Criteria for safe hepatic resection.
BACKGROUND
To lower morbidity after hepatic resection, the authors examined the influence of predictor variables including: age, sex, preoperative risk factors, serum total bilirubin level, plasma retention rate of indocyanine green at 15 minutes, underlying liver disease, operative blood loss, operation time, amount of whole blood transfused, vascular occlusion time, surgical procedure employed, and extent of hepatic resection.


METHODS
Between January 1990 and December 1992, 172 patients underwent hepatic resection based on our own criteria for hepatectomy, including the presence or absence of ascites, serum total bilirubin level, and the plasma retention rate of indocyanine green at 15 minutes in patients with chronic liver disease. The morbidity rate was 37.2%, and the hospital and operative mortality rates were 2.3% and 0.6%.


RESULTS
The multiple logistic model revealed that the risk of morbidity was increased by longer operation time, major hepatic resection, and preoperative cardiovascular disease.


CONCLUSIONS
Shortening the operation time without increasing operative blood loss and further modalities for making major hepatectomy safer are future problems to be addressed.
Miyagawa
S
S
First Department of Surgery, Shinshu University, School of Medicine, Matsumoto, Japan.
Makuuchi
M
M
Kawasaki
S
S
Kakazu
T
T
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods* / Q000401:mortality; D017052:Hospital Mortality; D006801:Humans; D007208:Indocyanine Green / Q000493:pharmacokinetics; D008107:Liver Diseases / Q000097:blood / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011183:Postoperative Complications / Q000401:mortality / Q000517:prevention & control; D012086:Reoperation; D012307:Risk Factors
D007208:Indocyanine Green; D001663:Bilirubin