Abstract
To determine whether the [14C] aminopyrine breath test (ABT) predicts surgical risk in patients with liver disease, it was obtained prior to various surgeries in 38 patients with known or suspected liver disease. A modified Child's classification was also determined. Six of the seven operative deaths (three Child's A, two B, two C) had ABTs less than 2.3%, while 30 of 31 survivors (24 Child's A, seven B) had ABTs greater than 2.3% (p less than 0.000018). Seven of the 16 patients with normal ABTs had biopsy-proven cirrhosis and had postoperative courses indistinguishable from the remainder of the group. We conclude that surgery in patients with ABTs less than 2.3% is associated with extremely high mortality. In addition, cirrhotics with normal ABTs tolerate elective surgery well.
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Selected References
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- Aranha G. V., Sontag S. J., Greenlee H. B. Cholecystectomy in cirrhotic patients: a formidable operation. Am J Surg. 1982 Jan;143(1):55–60. doi: 10.1016/0002-9610(82)90129-5. [DOI] [PubMed] [Google Scholar]
- Bruguera M., Bordas J. M., Rodés J. Asymptomatic liver disease in alcoholics. Arch Pathol Lab Med. 1977 Dec;101(12):644–647. [PubMed] [Google Scholar]
- Campbell D. P., Parker D. E., Anagnostopoulos C. E. Survival prediction in portacaval shunts: a computerized statistical analysis. Am J Surg. 1973 Dec;126(6):748–751. doi: 10.1016/s0002-9610(73)80062-5. [DOI] [PubMed] [Google Scholar]
- Greenwood S. M., Leffler C. T., Minkowitz S. The increased mortality rate of open liver biopsy in alcoholic hepatitis. Surg Gynecol Obstet. 1972 Apr;134(4):600–604. [PubMed] [Google Scholar]
- Hepner G. W., Vesell E. S. Quantitative assessment of hepatic function by breath analysis after oral administration of (14C)aminopyrine. Ann Intern Med. 1975 Nov;83(5):632–638. doi: 10.7326/0003-4819-83-5-632. [DOI] [PubMed] [Google Scholar]
- Lauterburg B. H., Bircher J. Expiratory measurement of maximal amino-pyrine demethylation in vivo: effect of phenobarbital, partial hepatectomy, protacaval shunt and bile duct ligation in the rat. J Pharmacol Exp Ther. 1976 Feb;196(2):501–509. [PubMed] [Google Scholar]
- Ludwig J., Garrison C. O., Baggenstoss A. H. Latent hepatic cirrhosis. A study of 95 cases. Am J Dig Dis. 1970 Jan;15(1):7–14. doi: 10.1007/BF02239341. [DOI] [PubMed] [Google Scholar]
- Mikkelsen W. P., Turrill F. L., Kern W. H. Acute hyaline necrosis of the liver. A surgical trap. Am J Surg. 1968 Aug;116(2):266–272. doi: 10.1016/0002-9610(68)90503-5. [DOI] [PubMed] [Google Scholar]
- Saunders J. B., Lewis K. O., Paton A. Early diagnosis of alcoholic cirrhosis by the aminopyrine breath test. Gastroenterology. 1980 Jul;79(1):112–114. [PubMed] [Google Scholar]
- Schneider J. F., Baker A. L., Haines N. W., Hatfield G., Boyer J. L. Aminopyrine N-demethylation: a prognostic test of liver function in patients with alcoholic liver disease. Gastroenterology. 1980 Dec;79(6):1145–1150. [PubMed] [Google Scholar]
- Schwartz S. I. Biliary tract surgery and cirrhosis: a critical combination. Surgery. 1981 Oct;90(4):577–583. [PubMed] [Google Scholar]
- Sedgwick C. E., Poulantzas J. K., Miller W. H. Portasystemic shunts in 102 patients with portal hypertension. N Engl J Med. 1966 Jun 9;274(23):1290–1293. doi: 10.1056/NEJM196606092742303. [DOI] [PubMed] [Google Scholar]
- Wirthlin L. S., Van Urk H., Malt R. B., Malt R. A. Predictors of surgical mortality in patients with cirrhosis and nonvariceal gastroduodenal bleeding. Surg Gynecol Obstet. 1974 Jul;139(1):65–68. [PubMed] [Google Scholar]