Background: Personal experience with major hepatic resections with particular regard to operative risk of this procedure in cirrhotic and non-cirrhotic patients is reported. Methods: 208 patients with malign (77.9%) or benign (22.1%) liver tumors underwent major hepatic resection from January 1981 to May 1997. Thirty-one patients were cirrhotics. A total of 115 right hepatectomies (55.2%), were performed, 33 right extended hepatectomies (15.8%), 35 left hepatectomies (16.8%), 16 left extended hepatectomies (7.6%) and 9 trisegmentectomies (3.4%). In 72 patients (34.6%) single or multiple associated resections were performed. Selected intraoperative and outcome data were compared in this retrospective analysis. Results: There were 9 intraoperative complications: 4 injuries of the contralateral biliary duct, 4 injuries of vena cava and 1 partial stricture of left hepatic vein. The mean operation time was 283±95.8 min. The mean units of blood transfused was 1.4±1.9. Patients with operative complications needed a median of 5 units of blood (range:1-11), (p = 0.001). Intra- and postoperative mortality was 2.8%. Eighty patients (38.4%) developed postoperative complications. Blood replacement is significantly higher in cirrhotic patients (p = 0.007). No other significant difference was found between cirrhotic and non-cirrhotic patients. Conclusions: Major hepatic resections for malignant and benign diseases can be performed safely with minimal morbidity and mortality in patients with normal liver and in selected cirrhotic patients classified as Pugh A.
|Translated title of the contribution||Major hepatic resections, operative and postoperative complications|
|Number of pages||6|
|Publication status||Published - 1998|
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