Effectiveness of perioperarive management of hepatectomised patients in biliary disease with Japanese Kampo medicine in terms of residual liver circulation

Abstract

Hepatectomy in biliary disease, such as hilar bile duct carcinoma or gallbladder carcinoma, sometimes cause postoperative hyperbilirubinemia or hepatic failure because of lack of large hepatic parenchyma. We have used Japanese Kampo medicine, Dai-kenchu-to (TU-100) and/or Inchin-ko-to (TU-135), for perioperative management of hepatectomised patients. We estimated effectiveness of combined use of TU-100 and TU-135 in hepatectomised patients with biliary disease from the view point of residual liver circulation. We divided hepatectomised patients with biliary disease into three groups retrospectively, Group A (Control group, n=16), Group B (TU-100, n=9), Group C (TU-100 and TU-135, n=17). Although preoperative KICG in group C shows significantly low level compared to that in group A, there are no significant difference in patient's background, such as age, gender, preoperative hepatic function, parenchymal hepatic resection rate, operative time, amount of intraoperative bleeding. Ratio of KICG on one week after operation to estimated postoperative KICG are 121.3±36.1 in group A, 119.6±23.7 in group B, 161.7±76.1 in group C. Group C shows significantly higher ratio than Group A (p<0.05). A combination use of TU-100 and TU-135 for hepatectomised patients with biliary disease possibly increased residual liver KICG, which indicates improvement of liver micro-circulation.