Table of Contents
HPB Surgery
Volume 11, Issue 4, Pages 241-248

Bilirubin as an Anti-oxidant for Surgical Stress: A Preliminary Report of Bilirubin Oxidative Metabolites

1First Department of Surgery, Kyushu University Faculty of Medicine, 3-1-1 Maidashi, Fukuoka 812-8582, Higashi-ku, Japan
2Division of Biochemical Examination, Kyushu University Faculty of Medicine, Fukuoka, Japan
3Department of Biochemical Genetics, Medical Research Institute, Tokyo Medical and Dental University, Tokyo, Japan

Received 30 September 1997; Accepted 5 February 1998

Copyright © 1999 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background Bilirubin has been recognized as an antioxidant. The purpose of this study was to examine whether bilirubin would act as an antioxidant for surgical stress in humans. Materials and Methods Serum bilirubin and urinary bilirubin oxidative metabolites (BOM) were measured in 96 patients who underwent surgery. The antioxidant activity of bilirubin was assessed using BOM measured by enzyme-linked immunosorbent assay with an anti-bilirubin monoclonal antibody. Results Serum bilirubin levels increased after surgery in all 96 patients (p<0.01), but did not correlate with operation time or blood loss (p=0.53 and p=0.28, respectively). BOM increased only in patients with major surgeries (p=0.048). Significant correlations between BOM and operation time and blood loss were found (p<0.01). Conclusions Bilirubin appears to act as an antioxidant for invasive surgery in humans. Urinary BOM could be a reliable marker for the degree of surgical stress.