Eleven cases of postoperative hepatic infarction following pancreato-biliary surgery.
BACKGROUND
Postoperative hepatic infarction is rare; therefore, clinical characteristics and outcomes of postoperative hepatic infarction after pancreatobiliary surgery have not been obvious.


METHODS
Eleven patients encountered hepatic infarction after pancreato-biliary surgery. Management, clinical course, and outcome of these 11 patients were retrospectively analyzed.


RESULTS
Possible causes of the hepatic infarction were inadvertent injury of the hepatic artery during lymph node dissection in five patients, right hepatic artery ligation in two patients, long-term clamp of the hepatic artery during hepatic arterial reconstruction in two patients, suturing for bleeding from the right hepatic artery in one patient, and celiac axis compression syndrome in one patient. Five of the 17 infarcts extended for one whole section of the liver, and distribution of the other 12 was less than one section. Ten patients discharged from hospital; however, one patient died of sepsis of unknown origin.


CONCLUSIONS
Attention should be paid to inadvertent injury of hepatic artery to prevent hepatic infarction. Hepatic infarctions after pancreato-biliary surgery seldom extend to the entire liver and most of them are able to be treated without intervention.
Miura
Fumihiko
F
Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan.
Asano
Takehide
T
Amano
Hodaka
H
Yoshida
Masahiro
M
Toyota
Naoyuki
N
Wada
Keita
K
Kato
Kenichoro
K
Hayano
Koichi
K
Kadowaki
Susumu
S
Shibuya
Makoto
M
Maeno
Sawako
S
Takada
Tadahiro
T
Eguchi
Tomoaki
T
D000368:Aged; D000369:Aged, 80 and over; D001662:Biliary Tract Surgical Procedures / Q000009:adverse effects; D004066:Digestive System Diseases / Q000601:surgery; D013505:Digestive System Surgical Procedures / Q000009:adverse effects*; D005260:Female; D006499:Hepatic Artery / Q000293:injuries*; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging / Q000209:etiology; D008099:Liver / Q000098:blood supply*; D008297:Male; D008875:Middle Aged; D010180:Pancreatectomy / Q000009:adverse effects; D016577:Pancreaticoduodenectomy / Q000009:adverse effects; D011859:Radiography; D012189:Retrospective Studies; D016896:Treatment Outcome