The reported incidence of postoperative hepatic dysfunction varies widely among investigators. To identify the factors contributing to postoperative hepatic dysfunction, the incidence of postoperative hepatic dysfunction and the factors
contributing to
it were determined in 98 patients who underwent one of three different types of surgery (59, 25 and 14 patients subjected to abdominal surgery, brain surgery and open heart surgery, respectively).
The overall incidence of postoperative hepatic dysfunction was 23.5%; the incidence of hyperbilirubinemia and abnormally elevated alanine aminotransferase (ALT) levels was 8.2% and 15.3%, respectively. The incidence of postoperative
hyperbilirubinemia
after abdominal surgery. Brain surgery and open heart surgery was 5.1%, 0% and 35.7%, respectively, and that of abnormally elevated ALT levels was 6.8%, 40% and 7.1%, respectively; thus, postoperative hyperbilirubinemia most commonly developed
after
open heart surgery, while abnormally elevated ALT levels were most frequently observed after brain surgery. The factors contributing to postoperative hyperbilirubinemia were the hypotensive episodes and the amount of transfused blood during or
shortly
after surgery. We concluded that the higher incidence of hyperbilirubinemia in patients who underwent open heart surgery may be related to the larger amount of transfusion and the development of hypotensive episodes rather than operution site per
se,
and the high incidence of postoperative abnormally elevated ALT levels in patients undergone brain surgery still remains to be investigated.
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