Surgical procedures in liver transplant patients: A monocentric retrospective cohort study
| Autor: | Tullio Piardi, Martin Lhuaire, Ganesh Nagarajan, Federica Dondero, Daniele Sommacale, Alain Sauvanet, Reza Kianmanesh, Jacques Belghiti, Patrick Pessaux |
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| Rok vydání: | 2017 |
| Předmět: |
Male
Liver surgery medicine.medical_specialty medicine.medical_treatment Population 030230 surgery Liver transplantation Cohort Studies 03 medical and health sciences Postoperative Complications 0302 clinical medicine Epidemiology medicine Humans education Retrospective Studies education.field_of_study business.industry Liver Diseases General surgery Retrospective cohort study General Medicine Middle Aged Surgical procedures Liver Transplantation Surgery Transplantation Female 030211 gastroenterology & hepatology Transplant patient France business Immunosuppressive Agents |
| Zdroj: | International Journal of Surgery. 41:58-64 |
| ISSN: | 1743-9191 |
| Popis: | Background Pre-existing chronic liver diseases and the complexity of the transplant surgery procedures lead to a greater risk of further surgery in transplanted patients compared to the general population. The aim of this monocentric retrospective cohort study was to assess the epidemiology of surgical complications in liver transplanted patients who require further surgical procedures and to characterize their post-operative risk of complications to enhance their medical care. Patients and methods From January 1997 to December 2011, 1211 patients underwent orthotropic liver transplantation in our center. A retrospective analysis of prospectively collected data was performed considering patients who underwent surgical procedures more than three months after transplantation. We recorded liver transplantation technique, type of surgery, post-operative complications, time since the liver transplant and immunosuppressive regimens. Results Among these, 161 patients (15%) underwent a further 183 surgical procedures for conditions both related and unrelated to the transplant. The most common surgical procedure was for an incisional hernia repair (n = 101), followed by bilioenteric anastomosis (n = 44), intestinal surgery (n = 23), liver surgery (n = 8) and other surgical procedures (n = 7). Emergency surgery was required in 19 procedures (10%), while 162 procedures (90%) were performed electively. Post-operative mortality and morbidity were 1% and 30%, respectively. According to the Dindo-Clavien classification, the most common grade of morbidity was grade III (46%), followed by grade II (40%). Conclusion Surgical procedures on liver transplanted patients are associated with a significantly high risk of complications, irrespective of the time elapsed since transplantation. |
| Databáze: | OpenAIRE |
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