Morbidity and mortality after hepatic resection in the modern era.
OBJECTIVE
The purpose of this study was to clarify the risk factors associated with complications following hepatic resections and discuss the appropriate types of perioperative management.


METHODS
A retrospective analysis was made of the complications in 355 patients undergoing hepatic resection between April 1985 and August 1992 at the Second Department of Surgery, Kyushu University Hospital. The patients were placed in two groups according to the occurrence of complications: patients with morbidity and/or mortality (187 patients); patients without either morbidity or mortality (168 patients).


RESULTS
The leading complications were the accumulation of fluid in the abdominal and pleural cavities along with septic complications. The only significant factory affecting morbidity and mortality among the preoperative medical conditions was the presence of diabetes while, in addition, the patients with morbidity and/or mortality had higher levels of perioperative transaminase and serum creatinine as compared with those in patients without either morbidity or mortality.


CONCLUSIONS
The perioperative strategies for reducing morbidity include the strict control of diabetes to reduce septic complications as well as preserve renal function, which can protect against the refractory accumulation of fluid in the peritoneal and pleural cavities.
Matsumata
T
T
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Taketomi
A
A
Kawahara
N
N
Higashi
H
H
Shirabe
K
K
Takenaka
K
K
D000328:Adult; D000368:Aged; D003404:Creatinine / Q000097:blood; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009017:Morbidity; D011183:Postoperative Complications / Q000097:blood / Q000453:epidemiology*; D012189:Retrospective Studies; D012307:Risk Factors; D015996:Survival Rate; D000637:Transaminases / Q000097:blood
D003404:Creatinine; D000637:Transaminases