title: Risk factors associated with intra-operative blood loss in hepatectomized patients with giant cavernous hemangioma of the liver.
abstract: OBJECTIVE
  The aim of this study was to clarify risk factors associated with intra-operative blood loss in hepatectomized patients with giant cavernous hemangioma (GCH) of the liver.
  
  
  METHODS
  Twenty patients with GCH of the liver were treated by hepatectomy. Eleven patients with intra-operative blood loss > 2000 ml (mean: 7145 +/- 7080 m; Group 1) were reviewed retrospectively and compared to 9 patients with intra-operative hemorrhage < 2000 ml (mean: 918 +/- 429 ml; Group 2).
  
  
  RESULTS
  Although there were no significant differences in pre-operative AST, ALT, and ICG-15 or fibrinogen and platelets between the two groups, pre-operative total bilirubin and fibrin degradation product (FDP) in Group 1 was significantly higher than in Group 2. Mean operation time and intra-operative blood transfusion in Group 1 versus Group 2 were 433 min vs. 213 min (p < 0.0001) and 3036 ml vs. 422 ml (p = 0.0072), respectively. The weight of resected liver (r = 0.821, p < 0.0001), maximum diameter of tumor (r = 0.782, p < 0.0001) and operation time (r = 0.748, p < 0.0001) were the most highly correlated with intra-operative blood loss, followed by pre-operative total bilirubin (r = 0.605, p = 0.0038), FDP level (r = 0.576, p = 0.0068) and intra-operative blood transfusion (r = 0.561, p = 0.0089).
  
  
  CONCLUSIONS
  These findings suggest that pre-operative management to reduce the tumor size, total bilirubin and FDP levels may be essential to minimize intra-operative hemorrhage and blood transfusion.
authors.affiliation: Second Department of Surgery, Shinshu University School of Medicine, Matsumoto, Japan.
authors.forename: K
authors.initials: K
authors.lastname: Hanazaki
authors.forename: S
authors.initials: S
authors.lastname: Kajikawa
authors.forename: A
authors.initials: A
authors.lastname: Matsushita
authors.forename: T
authors.initials: T
authors.lastname: Monma
authors.forename: N
authors.initials: N
authors.lastname: Koide
authors.forename: Y
authors.initials: Y
authors.lastname: Nimura
authors.forename: K
authors.initials: K
authors.lastname: Yazawa
authors.forename: M
authors.initials: M
authors.lastname: Hiraguri
authors.forename: W
authors.initials: W
authors.lastname: Adachi
authors.forename: J
authors.initials: J
authors.lastname: Amano
mesh_terms: D000328:Adult; D016063:Blood Loss, Surgical / Q000503:physiopathology*; D005260:Female; D005338:Fibrin Fibrinogen Degradation Products / Q000378:metabolism; D006392:Hemangioma, Cavernous / Q000097:blood / Q000601:surgery*; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000097:blood / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D005338:Fibrin Fibrinogen Degradation Products