[Evaluation of risk factors in the development of postoperative complications in patients undergoing liver resection for cancer].
A consecutive series of 134 hepatic resections for primary and metastatic cancer were analyzed to identify the risk factors for post-operative complications in patients with and without impaired liver reserve. Between January 1992 and January 2000 were performed 55 hepatectomies (41%--group 1) in 54 cirrhotic patients for hepatocarcinoma and 79 hepatic resections (59%--group 2) in 66 patients for primary hepatic malignancies or metastatic liver tumours in non cirrhotic liver. Among major postoperative complications bile leakage was recorded in 8 patients (6%) (6% with impaired liver reserve and 6% with normal reserve), hepatic failure in 8 patients (6%) (9% vs 4%; P = NS), ascites in 7 patients (5%) (11% vs 1%; P = 0.01), pneumonia in 4 patients (3%) (5% vs 1%; P = NS), intra-abdominal abscess in 2 patients (1%) (2% vs 1%; P = NS), postoperative haemorrhage in 2 patients (1%) (4% vs 0; P = NS), and gastrointestinal bleeding in 2 patients (1%) (4% vs 0; P = NS). There were 6 perioperative deaths (4%) (7% vs 2%; P = NS). The mean hospital stay was 21 +/- 10 days (range: 5-57) (24 +/- 10 vs 20 +/- 10; P = 0.02). Liver resection is a safe procedure even in cirrhotic patients providing they are well selected and there is minimal intraoperative blood loss.
Staudacher
C
C
Istituto di Chirurgia d'Urgenza, Università di Milano.
Chiappa
A
A
Zbar
A P
AP
Bertani
E
E
Biella
F
F
Haizhen
Z
Z
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000150:complications / Q000601:surgery; D001653:Bile Ducts, Intrahepatic / Q000601:surgery; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000150:complications / Q000601:surgery; D015179:Colorectal Neoplasms / Q000473:pathology; D003627:Data Interpretation, Statistical; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008103:Liver Cirrhosis / Q000150:complications; D008113:Liver Neoplasms / Q000150:complications / Q000556:secondary / Q000601:surgery*; D008297:Male; D008545:Melanoma / Q000556:secondary / Q000601:surgery; D008875:Middle Aged; D011183:Postoperative Complications / Q000209:etiology*; D012307:Risk Factors; D012509:Sarcoma / Q000556:secondary / Q000601:surgery; D013274:Stomach Neoplasms / Q000473:pathology