Significance of serum delta-bilirubin in patients with obstructive jaundice

Naoto Kozaki, Shuji Shimizu, Hidetaka Higashijima, Syoji Kuroki, Hiroyuki Yamashita, Koji Yamaguchi, Kazuo Chijiiwa, Masao Tanaka

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4 Citations (Scopus)

Abstract

Background. Delta-bilirubin is a bilirubin covalently bound with albumin, which is nontoxic and excreted neither in urine nor in bile. We previously reported that the percentage of delta-bilirubin increased after biliary drainage and that the rapidly excretable bilirubin fraction (total minus delta-bilirubin) was a better parameter to predict the effectiveness of biliary decompression in the dog model. The aim of the present study was to elucidate whether it is applicable to humans. Materials and Methods. The serum bilirubin concentration was measured and its fractions were analyzed by high-performance liquid chromatography in 22 patients with obstructive jaundice before and after biliary drainage. In addition, the patients were subgrouped into good and poor drainage groups according to the decline index of serum bilirubin to examine the significance of delta-bilirubin. Results. The concentration of total bilirubin decreased from 14.1 mg/dl before biliary drainage to 5.4 mg/dl 28 days after drainage. During this period, the percentage of conjugated bilirubin steeply declined from 47.1 to 8.8% and that of excretable bilirubin from 63.4 to 28.6%. In contrast, the proportion of serum delta-bilirubin increased from 36.6 to 71.4%. There was an inverse correlation between percentage of delta-bilirubin and total bilirubin concentration (r = -0.69, P < 0.01). In the good drainage group, the percentage of delta-bilirubin increased above 60% within 7 days after biliary drainage, but it did not reach 60% by 28 days in the poor drainage group. A decreasing rate of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction, was a better index than that of total bilirubin to assess the efficacy of biliary drainage (P < 0.01). Conclusions. The increase in the percentage of serum delta-bilirubin indicates an effectiveness of biliary drainage in man. An analysis of serum delta-bilirubin for 7 days can distinguish the good drainage patients from the poor drainage patients.

Original languageEnglish
Pages (from-to)61-65
Number of pages5
JournalJournal of Surgical Research
Volume79
Issue number1
DOIs
Publication statusPublished - Sep 1998

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Obstructive Jaundice
Bilirubin
Serum
Drainage

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Kozaki, N., Shimizu, S., Higashijima, H., Kuroki, S., Yamashita, H., Yamaguchi, K., ... Tanaka, M. (1998). Significance of serum delta-bilirubin in patients with obstructive jaundice. Journal of Surgical Research, 79(1), 61-65. https://doi.org/10.1006/jsre.1998.5357

Significance of serum delta-bilirubin in patients with obstructive jaundice. / Kozaki, Naoto; Shimizu, Shuji; Higashijima, Hidetaka; Kuroki, Syoji; Yamashita, Hiroyuki; Yamaguchi, Koji; Chijiiwa, Kazuo; Tanaka, Masao.

In: Journal of Surgical Research, Vol. 79, No. 1, 09.1998, p. 61-65.

Research output: Contribution to journalArticle

Kozaki, N, Shimizu, S, Higashijima, H, Kuroki, S, Yamashita, H, Yamaguchi, K, Chijiiwa, K & Tanaka, M 1998, 'Significance of serum delta-bilirubin in patients with obstructive jaundice', Journal of Surgical Research, vol. 79, no. 1, pp. 61-65. https://doi.org/10.1006/jsre.1998.5357
Kozaki, Naoto ; Shimizu, Shuji ; Higashijima, Hidetaka ; Kuroki, Syoji ; Yamashita, Hiroyuki ; Yamaguchi, Koji ; Chijiiwa, Kazuo ; Tanaka, Masao. / Significance of serum delta-bilirubin in patients with obstructive jaundice. In: Journal of Surgical Research. 1998 ; Vol. 79, No. 1. pp. 61-65.
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abstract = "Background. Delta-bilirubin is a bilirubin covalently bound with albumin, which is nontoxic and excreted neither in urine nor in bile. We previously reported that the percentage of delta-bilirubin increased after biliary drainage and that the rapidly excretable bilirubin fraction (total minus delta-bilirubin) was a better parameter to predict the effectiveness of biliary decompression in the dog model. The aim of the present study was to elucidate whether it is applicable to humans. Materials and Methods. The serum bilirubin concentration was measured and its fractions were analyzed by high-performance liquid chromatography in 22 patients with obstructive jaundice before and after biliary drainage. In addition, the patients were subgrouped into good and poor drainage groups according to the decline index of serum bilirubin to examine the significance of delta-bilirubin. Results. The concentration of total bilirubin decreased from 14.1 mg/dl before biliary drainage to 5.4 mg/dl 28 days after drainage. During this period, the percentage of conjugated bilirubin steeply declined from 47.1 to 8.8{\%} and that of excretable bilirubin from 63.4 to 28.6{\%}. In contrast, the proportion of serum delta-bilirubin increased from 36.6 to 71.4{\%}. There was an inverse correlation between percentage of delta-bilirubin and total bilirubin concentration (r = -0.69, P < 0.01). In the good drainage group, the percentage of delta-bilirubin increased above 60{\%} within 7 days after biliary drainage, but it did not reach 60{\%} by 28 days in the poor drainage group. A decreasing rate of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction, was a better index than that of total bilirubin to assess the efficacy of biliary drainage (P < 0.01). Conclusions. The increase in the percentage of serum delta-bilirubin indicates an effectiveness of biliary drainage in man. An analysis of serum delta-bilirubin for 7 days can distinguish the good drainage patients from the poor drainage patients.",
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AU - Kozaki, Naoto

AU - Shimizu, Shuji

AU - Higashijima, Hidetaka

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AU - Yamashita, Hiroyuki

AU - Yamaguchi, Koji

AU - Chijiiwa, Kazuo

AU - Tanaka, Masao

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AB - Background. Delta-bilirubin is a bilirubin covalently bound with albumin, which is nontoxic and excreted neither in urine nor in bile. We previously reported that the percentage of delta-bilirubin increased after biliary drainage and that the rapidly excretable bilirubin fraction (total minus delta-bilirubin) was a better parameter to predict the effectiveness of biliary decompression in the dog model. The aim of the present study was to elucidate whether it is applicable to humans. Materials and Methods. The serum bilirubin concentration was measured and its fractions were analyzed by high-performance liquid chromatography in 22 patients with obstructive jaundice before and after biliary drainage. In addition, the patients were subgrouped into good and poor drainage groups according to the decline index of serum bilirubin to examine the significance of delta-bilirubin. Results. The concentration of total bilirubin decreased from 14.1 mg/dl before biliary drainage to 5.4 mg/dl 28 days after drainage. During this period, the percentage of conjugated bilirubin steeply declined from 47.1 to 8.8% and that of excretable bilirubin from 63.4 to 28.6%. In contrast, the proportion of serum delta-bilirubin increased from 36.6 to 71.4%. There was an inverse correlation between percentage of delta-bilirubin and total bilirubin concentration (r = -0.69, P < 0.01). In the good drainage group, the percentage of delta-bilirubin increased above 60% within 7 days after biliary drainage, but it did not reach 60% by 28 days in the poor drainage group. A decreasing rate of total bilirubin minus delta-bilirubin, the excretable bilirubin fraction, was a better index than that of total bilirubin to assess the efficacy of biliary drainage (P < 0.01). Conclusions. The increase in the percentage of serum delta-bilirubin indicates an effectiveness of biliary drainage in man. An analysis of serum delta-bilirubin for 7 days can distinguish the good drainage patients from the poor drainage patients.

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