Hepatic functional reserve in patients with obstructive jaundice: an assessment by the redox tolerance test.

Abstract

PURPOSE:

Hepatic mitochondrial response to oral glucose load (redox tolerance test) was evaluated as an indicator of hepatic functional reserve of patients with obstructive jaundice.

PATIENTS AND METHODS:

The redox tolerance test was performed in 29 patients with obstructive jaundice before percutaneous transhepatic biliary drainage and 2 weeks after the procedure.

RESULTS:

The redox tolerance index (RTI) before drainage was not related to conventional parameters other than albumin, but was significantly associated with bilirubin half-life (P < 0.01). Of 19 patients with an RTI > or = 0.5 before drainage, all maintained similar values after drainage and experienced satisfactory clinical courses, even after major surgery. Of 10 patients with an RTI < 0.5 before drainage, 5 showed improvement and 5 deteriorated after drainage. Four of the latter 5 died within 60 days after drainage. The hospital mortality was significantly greater in patients with initial RTI < 0.5 than in patients with RTI > or = 0.5 (P < 0.01).

CONCLUSION:

The redox tolerance test is useful for evaluating hepatic functional reserve and prognosis in patients with obstructive jaundice.

• Authors: T Tsubono, K Tsukada, K Hatakeyama
• Journal: American journal of surgery (Am J Surg) Vol. 169 Issue 3 Pg. 300-3 (Mar 1995) ISSN: 0002-9610 [Print] United States
• PMID: 7879830 (Publication Type: Clinical Trial, Controlled Clinical Trial, Journal Article)

Chemical References

• Bilirubin

Topics

• Adult
• Aged
• Aged, 80 and over
• Bilirubin (blood)
• Cholestasis (metabolism, surgery)
• Female
• Glucose Tolerance Test
• Hospital Mortality
• Humans
• Liver Function Tests
• Male
• Middle Aged
• Mitochondria, Liver (metabolism)
• Oxidation-Reduction
• Prognosis
• Severity of Illness Index
• Sphincterotomy, Transduodenal (mortality)