Objective：To investigate the features of postoperative serum bilirubin changes and the clinical factors associated with high serum bilirubin level in patients with primary liver cancer  after resection.
Methods：The clinical data of 97 patients with primary liver cancer who underwent hepatectomy were analysed retrospectively. The cases were divided into two groups: high serum bilirubin group and normal bilirubin group, respectively, according to serum bilirubin level during two weeks after operation. The features of postoperative serum bilirubin changes and the causitive factors of postoperative high serum bilirubin were analyzed.
Results：The postoperative serum bilirubin reached the peak value［(21.5±9.2)μmol/L］ on d4, and then decreased to normal on d14 in normal bilirubin group. But in high serum bilirubin group the postoperative serum bilirubin reached the peak value［(49.2±25.4)μmol/L］ on the d7, and was still twice more than the normal value ［(36.1±17.6)μmol/L］on  d14. Preoperative serum bilirubin,Child′s grade, types of hepatic vascular occlusion, blood loss, blood transfusion, and postoperative hyponatremia were related with postoperative high serum bilirubin. Preoperative serum bilirubin was an independent factor in predicting postoperative high serum bilirubin(OR=5.406,χ2=11.319,P=0.001）.
Conclusions：It is very important to monitor the posthepatectomy serum bilirubin value dynamically. Preventon and treatment of the causes of perioperative high serum bilirubin may help to decrease the complications of hepatectomy.