Trends in Post-Operative Liver Function Recovery: A Comparison of Right Hepatectomy in Living Donor Liver Resections (LDLR) and Hepatobiliary Diseases (HPB)

Abstract

Aim: To examine the trends in the biochemical parameters of liver function occurring postoperatively in Right Hepatectomy for Living donor liver resections (LDLR) and for Hepatobiliary (HPB) diseases. Introduction: Right hepatectomy is the preferred method for living donor liver resections. There isn't much data comparing the trend of the biochemical parameters post operatively between right hepatectomy operations done for HPB and for LDLR though the surgical technique remains the same. It is presumed that living donor operations show more acute worsening post operatively than the HPB patients as the remnant liver in the donor does not get sufficient time to compensate as compared to the non- diseased liver in Hepatobiliary diseases which tend to hypertrophy and compensate for the diseased segments during the course of the illness. Methods: 52 consecutive patients with Hepatobiliary diseases (HPB) who underwent Right Hepatectomy and did not have prior hepatitis or fibrosis and 38 consecutive living donor liver resections (LDLR) patients were included in this comparative study. The patients were from similar age group and comparative previous medical history. Patients with Hepatobiliary resections who had normalized liver function prior to the surgery were selected in the study. Liver function tests (LFT) were analyzed starting from day 0 until their liver enzymes had stabilized post operatively. The data was analyzed using standard statistical methods and t-test. Results: There was a significant statistical difference in the liver enzymes - Alkaline phosphatase, SGOT and SGPT values in the early phase. Though the time required for enzyme and other liver functions to stabilize was about the same, the gradient of the trend lines for the HPB group was significantly steeper especially for Alkaline phosphatase (p= 0.0004), SGOT (p=0.008) and SGPT (0.007) in the early post- operative period. Conclusion: In this retrospective analysis we found that though curve for the derangements and recovery for liver function followed a similar pattern, the degree of severity was worse in HPB patients.