Comparative analysis of postoperative morbidity according to type and extent of hepatectomy.
OBJECTIVE
The aim of our retrospective study was to compare the factors contributing to postoperative complications according to the extent of hepatectomy.


METHODS
We examined 166 patients with hepatobiliary carcinoma who underwent hepatectomy. Patients were divided into three groups according to the type and extent of hepatectomy: 1) left lobectomy (n=27), 2) right lobectomy or posterior segmentectomy (n=55) and 3) other hepatectomies (n=84). Patient demographics, major complications (infection, ascites, pleural effusion, atelectasis, static symptoms of the stomach, biliary leakage and hepatic failure) after hepatectomy were analyzed.


RESULTS
In patients with obstructive jaundice, lobectomy was the most commonly performed operation due to the extent of tumor along the main hepatic duct. Prolonged ascites or massive pleural effusion was frequently observed after right lobectomy (p=0.001) and posterior segmentectomy (p=0.002). However, the incidences of these complications were similar in patients with chronic viral hepatitis. Symptoms related to gastric stasis and biliary leakage were significantly more common after left lobectomy than other surgeries. The incidence of hepatic failure was higher (p<0.05) after major hepatectomy, particularly right lobectomy, than other surgeries.


CONCLUSIONS
Our results emphasize the need to understand characteristics of specific complications occurring after different types of hepatic resection surgery to prevent post-hepatectomy complications.
Nanashima
Atsushi
A
Division of Surgical Oncology, Department of Translational Medical Sciences Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@alpha.med.nagasaki-u.ac.jp
Yamaguchi
Hiroyuki
H
Shibasaki
Shinichi
S
Ide
Noboru
N
Morino
Shigeyuki
S
Sumida
Yorihisa
Y
Tsuji
Takashi
T
Sawai
Terumitsu
T
Nakagoe
Tohru
T
Nagayasu
Takeshi
T
D000328:Adult; D000368:Aged; D001201:Ascites / Q000453:epidemiology / Q000209:etiology; D001650:Bile Duct Neoplasms / Q000601:surgery*; D001658:Biliary Fistula / Q000453:epidemiology / Q000209:etiology; D006528:Carcinoma, Hepatocellular / Q000601:surgery*; D018281:Cholangiocarcinoma / Q000601:surgery*; D003430:Cross-Sectional Studies; D005260:Female; D018589:Gastroparesis / Q000453:epidemiology / Q000209:etiology; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D015994:Incidence; D017093:Liver Failure / Q000453:epidemiology / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D010996:Pleural Effusion / Q000453:epidemiology / Q000209:etiology; D011183:Postoperative Complications / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies; D012306:Risk