Characteristic risk factors in cirrhotic patients for posthepatectomy complications: comparison with noncirrhotic patients
| Autor: | Daihiko Eguchi, Kenji Takenaka, Hirofumi Kawanaka, Shinji Itoh, Daisuke Korenaga, Akinori Egashira, Hideaki Uchiyama, Toshiro Okuyama, Masahiro Tateishi, Takahiro Higashi |
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| Rok vydání: | 2014 |
| Předmět: |
Adult
Liver Cirrhosis Male medicine.medical_specialty Blood transfusion Cirrhosis Multivariate analysis Carcinoma Hepatocellular medicine.medical_treatment Risk Assessment Statistics Nonparametric Cohort Studies Postoperative Complications Blood loss Reference Values Cause of Death Medicine Hepatectomy Humans Neoplasm Invasiveness Hospital Mortality Risk factor Aged Neoplasm Staging Retrospective Studies Aged 80 and over Univariate analysis business.industry Liver Neoplasms General Medicine Middle Aged medicine.disease Prognosis Survival Analysis Surgery Logistic Models Treatment Outcome Hepatocellular carcinoma Female business Complication |
| Zdroj: | The American surgeon. 80(2) |
| ISSN: | 1555-9823 |
| Popis: | There seemed to be characteristic risk factors in cirrhotic patients for posthepatectomy complications because these patients have less hepatic reserve as compared with noncirrhotic patients. The aim of the current study was to identify these characteristic risk factors in cirrhotic patients. We performed 419 primary hepatectomies for hepatocellular carcinoma. The patients were divided into the cirrhotic group (n = 198) and the noncirrhotic group (n = 221), and the risk factors for posthepatectomy complications were compared between the groups. Thirty-six cirrhotic patients (18.2%) experienced Clavien's Grade III or more complications. Tumor size, intraoperative blood loss, duration of operation, major hepatectomy (two or more segments), and necessity of blood transfusion were found to be significant risk factors in univariate analyses. Multivariate analysis revealed that major hepatectomy and intraoperative blood loss were independent risk factors for posthepatectomy complications in patients with cirrhosis. On the other hand, the duration of operation was only an independent risk factor for posthepatectomy complication in noncirrhotic patients. Cirrhotic patients should avoid a major hepatectomy and undergo a limited resection preserving as much liver tissue as possible and meticulous surgical procedures to lessen intraoperative blood loss are mandatory to prevent major posthepatectomy complications. |
| Databáze: | OpenAIRE |
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