[Risk factors of hepatectomies: results of a multivariate study. Apropos of 113 cases].
113 consecutive elective liver resections were performed in 107 patients over a period of 8 and half years. The indication was a malignant tumor in 75.2% of cases and a benign lesion in 24.8%. The remnant liver was pathologic in 22.1% of cases (16 steatosis, 8 cirrhosis and 1 fibrosis). The extent of liver resection was major (> or = 3 segments according to Couinaud classification) in 60 cases and minor in 45 cases. No intraoperative mortality occurred. Hospital mortality was 4.4%. Major complications, including death, occurred in 36.3% of cases (41/113). Statistical analysis of various risk factors was performed, regarding age, type of liver disease, cholestasis, surgical approach, extent of resection, type of hepatic vascular clamping, liver ischemia, quality of the remnant liver, intraoperative hemorrhage and length of the procedure. Multivariate analysis demonstrated three major statistically significant risk factors: pre operative cholestasis (r = 0.373; p = 0.0012), extent of liver resection (r = 0.377; p = 0.0011), and intra operative blood transfusion (r = 0.364; p < 0.008) with a global correlation coefficient of 0.582 (p < 0.0001). These results should lead to better surgical selection for liver resection and reduced morbidity and mortality.
Gavelli
A
A
Département de Chirurgie, Centre Hospitalier Princesse Grace, Monaco.
Ghiglione
B
B
Huguet
C
C
D000038:Abscess / Q000209:etiology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology; D005260:Female; D006470:Hemorrhage / Q000209:etiology*; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D010532:Peritoneal Diseases / Q000209:etiology*; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors
Facteurs de risque des hépatectomies: résultats d'une étude multivariée. A propos de 113 cas.