Predictors of posthepatectomy ascites with or without previous portal vein embolization.

Autor:	Hoekstra LT; Departments of Surgery, Academic Medical Center, Amsterdam, The Netherlands. L.T.Hoekstra@amc.uva.nl, Wakkie T, Busch OR, Gouma DJ, Beuers U, van Gulik T
Jazyk:	angličtina
Zdroj:	Digestive surgery [Dig Surg] 2012; Vol. 29 (6), pp. 468-74. Date of Electronic Publication: 2013 Jan 07.
DOI:	10.1159/000345583
Abstrakt:	Aim: 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). Conclusion: 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. (Copyright © 2012 S. Karger AG, Basel.)
Databáze:	MEDLINE
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