Introduction: Herein we analyzed causes and foreseeable risk factors linked to postoperative morbidity on the ground of data derived from a single center surgical population. Methods: From 1989 to 2005, 287 consecutive patients had liver resection for either Hcc or liver metastasis at our department. We performed 22 major hepatectomy, 20 left hepatectomy, 14 trisegmen- tectomy, 77 bisegmentectomy and/or left lobectomy, 74 segmentec- tomy and 80 wedge resection.Results: In-hospitalmortalityratewas4.5%.Morbidityratewas 47.7%, caused by the rising of ascites (10%), hepatic insufficiency (19%), biliary fistula (6%), hepatic abscess (25%), hemoperitoneum (10%) and pleural effusion (30%). The variables responsible of the rising of complication are: Pringle maneuver 20 (p 0.001), the type of liver resection procedure: major hepatectomy (p 0.02), left hepatectomy (p 0.04), trisegmentectomy (p 0.04), bisegmentec- tomy and/or left lobectomy (p 0.04); and the request of an amount of blood transfusion 600 cc (p 0.04); also both liver dysfunction, in particular Child A vs. B and C (p 0.01) and histopathological grading (p 0.01) are associated with an high rate of post-surgical complication in HCC cases. Conclusion: Complications arisen during postoperative time, although could be treated, delay patient’s recovery and resumption of liver function; the evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of surgical treatment should play the same role as other factors weighted in the selection of patient eligible to liver resection.
Postoperative Complications Linked to Resective Surgery for Liver Tumor
UZZAU, Alessandro
2006-01-01
Abstract
Introduction: Herein we analyzed causes and foreseeable risk factors linked to postoperative morbidity on the ground of data derived from a single center surgical population. Methods: From 1989 to 2005, 287 consecutive patients had liver resection for either Hcc or liver metastasis at our department. We performed 22 major hepatectomy, 20 left hepatectomy, 14 trisegmen- tectomy, 77 bisegmentectomy and/or left lobectomy, 74 segmentec- tomy and 80 wedge resection.Results: In-hospitalmortalityratewas4.5%.Morbidityratewas 47.7%, caused by the rising of ascites (10%), hepatic insufficiency (19%), biliary fistula (6%), hepatic abscess (25%), hemoperitoneum (10%) and pleural effusion (30%). The variables responsible of the rising of complication are: Pringle maneuver 20 (p 0.001), the type of liver resection procedure: major hepatectomy (p 0.02), left hepatectomy (p 0.04), trisegmentectomy (p 0.04), bisegmentec- tomy and/or left lobectomy (p 0.04); and the request of an amount of blood transfusion 600 cc (p 0.04); also both liver dysfunction, in particular Child A vs. B and C (p 0.01) and histopathological grading (p 0.01) are associated with an high rate of post-surgical complication in HCC cases. Conclusion: Complications arisen during postoperative time, although could be treated, delay patient’s recovery and resumption of liver function; the evaluation of causes and foreseeable risk factors linked to postoperative morbidity during the planning of surgical treatment should play the same role as other factors weighted in the selection of patient eligible to liver resection.File | Dimensione | Formato | |
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