Ischemic Liver Injury After Complete Occlusion of Hepatic Artery in the Treatment of Delayed Postoperative Arterial Bleeding.
BACKGROUND
Delayed postoperative arterial bleeding is rare and may be life-threatening. When the bleeding source is the hepatic artery, complete ligation or embolization from the proximal to the distal area of the ruptured lesion usually results in complete occlusion of hepatic arterial flow.


METHODS
To evaluate the frequency and severity of ischemic liver injury following complete hepatic artery occlusion, a retrospective study was conducted. Patients who underwent complete hepatic artery occlusion in the treatment of delayed postoperative arterial bleeding between January 2007 and December 2014 in our institution were reviewed. Changes of hepatic function and rates of associated complications and prognosis were analyzed.


RESULTS
A total of 24 patients experienced 26 episodes of bleeding. Nineteen experienced transient liver enzyme elevation alone. There were no signs of acute liver failure after complete hepatic artery occlusion. The rates of liver infarction and liver abscess were 23.8 % (5/21) and 19 % (4/21), respectively. The 30-day mortality rate was 8.3 % (2/24).


CONCLUSIONS
Complete occlusion of the hepatic artery does not always result in severe hepatic ischemic injury. As a common cause of delayed postoperative bleeding, intra-abdominal infection may be fatal when it is not controlled successfully.
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Ji
J
Zhang
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Hong-gang
HG
Qian
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Jia-hua
JH
Leng
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Hui
H
Qiu
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Jian-hui
JH
Wu
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Bo-nan
BN
Liu
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Cheng-peng
CP
Li
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Meng
M
Wei
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Qiao
Q
Liu
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China.
Ang
A
Lv
Department of Hepato-Pancreatic Biliary Surgery, Key laboratory of Carcinogenesis and Translational Research, Ministry of Education, Peking University School of Oncology, Beijing Cancer Hospital and Institute, Beijing, People's Republic of China. drhaochunyi@163.com.
Chun-yi
CY
Hao
D000328:Adult; D000368:Aged; D013505:Digestive System Surgical Procedures / Q000009:adverse effects; D004621:Embolization, Therapeutic / Q000009:adverse effects*; D005260:Female; D006499:Hepatic Artery; D006801:Humans; D059413:Intraabdominal Infections / Q000150:complications; D008026:Ligation / Q000009:adverse effects; D008107:Liver Diseases / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000628:therapy*; D012189:Retrospective Studies
Acute liver failure; Delayed postoperative arterial bleeding; Hepatic artery occlusion