The Serum Alkaline Phosphatase Ratio as an Early Indicator of Postoperative Liver Failure

One hundred and thirty-two patients patients underwent hepatectomy for hepatocellular carcinoma at the Department of Surgery 「,Yamaguchi University School of Medicine. The subjects included 8 patients with liver failure and 124 patients without seriously abnormal hepatic function. We calculated the relationship between the pre-and postoperative serum ALP concentration as the serum alkaline phosphatase ratio (ALPR). The ALPR of most patients with liver failure markedly decreased to less than 0.4. The mean ALPR of the non-failure group was significantly higher than that of the liver failure group on POD 1 (Liver failure 0.31±0.18 vs. Non-failure 0.69±0.03, P<0.01). The sensitivity of the ALPR for predicting liver failure was 87.5%, the specificity was 95.2%, the diagnostic accuracy was 94.7% for an ALPR below 0.4 on the first day. Patients with an ALPR greater than 0.4 had a good prognosis regardless of hyperbilirubinemia on the first day after hepatectomy. Thus, the ALPR appears to be one of the most reliable indicators of prognosis after hepatectomy for hepatocellular carcinoma.

術後肝不全

血清アルカリフォスファターゼ比

肝切除術

肝細胞癌

血清総ビリルビン値