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Postoperative jaundice after cardiac surgery

Hepatobiliary & Pancreatic Diseases International 2007年第4期6卷 383-387页

作者： Aikaterini Mastoraki Emmanouil Karatzis Sotiria Mastoraki Ioannis Kriaras Petros Sfirakis Stefanos Geroulanos Department of Surgical Intensive Care Unit Onassis Cardiac Surgery Center356 Sygrou Ave17674 AthensGreece

BACKGROUND:The frequency and pattern of hyperbili-rubinemia after open-heart surgery and its severe perioperative complications are not well clarified. The purpose of this study was to investigate the incidence and nature of postoperative jaundice in patients undergoing cardiac operation,to analyze the determinants,and to identify the clinical significance of this complication with regard to the associated morbidity and mortality. METHODS:A prospective observational study was made during the period of 2003-2004 in a Surgical Intensive Care Unit of a Cardiac Surgery Center,Athens. One hundred twenty-eight adult patients for open heart surgery were divided into three groups. Group A included 50 patients who underwent coronary artery bypass crafting(CABG),group B 31 patients who were subjected to aortic valve replacement(AVR)+CABG and group C 47 patients who underwent mitral valve replacement(MVR)+CABG. Aminotransferases,alkaline phosphatase,gamma-glutamyl-transpeptidase and both types of bilirubin were determined at admission,24 hours after the operation and thereafter according to clinical evolution. The presence of jaundice was associated with elevated serum bilirubin above 3 mg/dl. RESULTS:Hyperbilirubinemia developed in 34 patients(26.5%). The incidence of postoperative jaundice was higher in patients who were subjected to MVR+CABG than to CABG and AVR+CABG. Hyperbilirubinemia was correlated with prolonged cardiopulmonary by-passtime(Pconjugated bilirubin. CONCLUSIONS:Although hyperbilirubinemia seems to be multifactorial,the type of operation,the preoperative hepatic dysfunction due to advanced heart failure(NYHA Ⅱ-Ⅲ) and the decreased hepatic flow during the operation seem to determine the incidence of jaundice.

关键词： jaundice conjugated bilirubin cardiac surgery prognosis

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Dubin-Johnson Syndrome in Pregnancy: Case Report and Literature Review

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Maternal-Fetal Medicine 2020年第2期2卷 119-122页

作者： Jie Ruan Mei-Fan Duan Dong Liu Qiang Wei Department of Obstetrics and Gynecology Key Laboratory of Birth Defects and Related Diseases in Women and Children of Ministry of EducationWest China Second HospitalSichuan UniversitySichuan 610041China

To editor:Dubin-Johnson syndrome is a rare hereditary autosomal recessive disorder that was first described in 1954.1 Incidence of Dubin-Johnson syndrome in the general population is unclear,it appears to be slightly more common in males and its incidence varies widely with ethnicity and geography.2 Age at onset varies widely,between 10 weeks and 76 years.

关键词： Hyperbilirubinemia conjugated bilirubin Jaundice Perinatal outcomes

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