title: Predictors of posthepatectomy ascites with or without previous portal vein embolization.
abstract: OBJECTIVE
  To identify predictors of postoperative ascites after liver resection for patients with or without preoperative portal vein embolization (PVE).
  
  
  METHODS
  Patients undergoing PVE prior to hepatectomy (PVE group; n = 37) were compared with patients who underwent liver resection without PVE (n = 503). Ascites was defined as postoperative daily drainage of clear ascitic fluid exceeding 200 ml/day. Pre-, intra-, and postoperative variables were retrospectively analyzed using uni- and multivariate analyses.
  
  
  RESULTS
  Postoperative ascites was present in 13.5% (5/37) of patients who underwent PVE before hepatectomy, compared to 5.8% (29/503) in the group undergoing liver resection without PVE (p = 0.061). In all patients, cirrhosis (OR 54.505, p < 0.001), operation time (OR 1.004, p = 0.014), and the use of the Pringle maneuver (OR 2.336, p = 0.041) were independent risk predictors for ascites in multivariate analysis. In PVE patients, cirrhosis (OR 0.156, p < 0.001) was the only independent significant predictor of ascites after resection. In patients undergoing liver resection without PVE, independent risk factors with multivariate analysis were operation time (OR 1.005, = 0.001) and cirrhosis (OR 26.609, p < 0.001).
  
  
  CONCLUSIONS
  Operation time and the use of the Pringle maneuver were significant predictors of ascites after hepatectomy. Cirrhosis was a significant risk factor associated with postoperative ascites.
authors.affiliation: Departments of Surgery, Academic Medical Center, Amsterdam, The Netherlands. L.T.Hoekstra@amc.uva.nl
authors.forename: Lisette T
authors.initials: LT
authors.lastname: Hoekstra
authors.forename: Thijs
authors.initials: T
authors.lastname: Wakkie
authors.forename: Olivier R C
authors.initials: OR
authors.lastname: Busch
authors.forename: Dirk J
authors.initials: DJ
authors.lastname: Gouma
authors.forename: Ulrich
authors.initials: U
authors.lastname: Beuers
authors.forename: Thomas
authors.initials: T
authors.lastname: van Gulik
mesh_terms: D000328:Adult; D000368:Aged; D001201:Ascites / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications; D008107:Liver Diseases / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D061646:Operative Time; D011169:Portal Vein; D011183:Postoperative Complications / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology*; D011300:Preoperative Care / Q000379:methods*; D012189:Retrospective Studies; D012307:Risk Factors