Abstract
The importance of monitoring alkaline phosphatase as a parameter of the posthepatectomy course was studied in the 46 massively hepatectomized patients with normal (17 cases), cirrhotic (21 cases) or obstructive jaundiced (8 cases) livers. A total bilirubin level over 5.0 mg/dl in the postoperative course was defined as hepatic failure. The alkaline phosphatase level in uneventful cases reached the bottom just after the operation and subsequently increased with decreasing total bilirubin level. In the early postoperative period, the rate of increas in serum alkaline phsphatase was higher in normal liver than in the other groups. No correlation between the prothrombin time and the alkaline phosphatase level was found in the postoperative course. In contrast, in the patients with progressive hepatic failure, the alkaline phosphatase level decreased and remained lower level. These findings lead us to the conclusion that after massive hepatectomy, monitoring of serum alkaline phsphatase is useful in predicting bile secretion capacity and the regenerative process in the remnant liver.
