Postoperative evaluation of C-tube drainage after hepatectomy.
OBJECTIVE
In spite of recent advances in liver surgery, biliary complications remain a common cause of major morbidity after hepatectomy.


METHODS
We studied the postoperative evaluation of 28 hepatectomied patients with transcystic duct tube (C-tube) drainage (C-group), compared with 38 hepatectomied patients without C-tubes (NC-group), in terms of preoperative clinical profiles of patients, intraoperative findings and procedures, postoperative management and bile leakage, daily output of bile, liver function and postoperative infections.


RESULTS
There were no significant differences in the preoperative clinical profiles of patients and postoperative management between the two groups. In intraoperative findings and procedures, the tumor size, weight of the resected liver, operation time and operative blood loss were higher in the C-group than those in the NC-group. Therefore, the operative procedure was more serious in the C-group than that in the NC-group. However, bile leakage was observed in only one of 28 patients (3.6%) in the C-group and 10 of 38 patients (26.3%) in the NC-group, that is, bile leakage occurred less frequently in the C-group than in the NC-group. The daily output of bile in the C-group was thought to be enough to decompress the biliary tree. In liver function, aspartate aminotransferase and alanine aminotransferase had lower levels in the C-group than those in the NC-group with bile leakage. White blood cell count, C-reactive protein and body temperature were closer to the normal range in the C-group than those in the NC-group with bile leakage.


CONCLUSIONS
C-tube drainage after hepatectomy is thought to be useful for decreasing postoperative complications, especially bile leakage.
Department of Surgery, Wakayama Rosai Hospital, 435-Koya, Wakayama 640-8505, Japan. hotta@naxnet.or.jp
Tsukasa
T
Hotta
Yasuhito
Y
Kobayashi
Katsutoshi
K
Taniguchi
Kiyofumi
K
Johata
Masaki
M
Sahara
Teiji
T
Naka
Tsunehiro
T
Maeda
Hiroshi
H
Tanimura
D000368:Aged; D002097:C-Reactive Protein / Q000032:analysis; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D003549:Cystic Duct; D019299:Decompression, Surgical / Q000379:methods*; D004322:Drainage; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010288:Parenteral Nutrition; D011183:Postoperative Complications / Q000517:prevention & control; D011184:Postoperative Period
D002097:C-Reactive Protein