Abstract：
:The safe and permissible limits of hepatectomy in obstructive jaundice patients and the usefulness of preoperative portal embolization (PE) for increasing the limit for safe hepatectomy were examined. We classified 416 patients with hepatectomy performed over 9 years under the following headings: normal liver function (n = 242); chronic hepatitis (n = 71); liver cirrhosis (n = 64); and liver after relief of obstructive jaundice (n = 39). Hepatectomy was done after the total bilirubin level was reduced below 3 mg/dl by preoperative biliary drainage. Factors influencing the maximum total bilirubin level measured within 2 weeks after hepatectomy were investigated, and this level was taken to reflect the degree of surgical stress. PE was carried out in 18 patients with obstructive jaundice. The maximum total bilirubin, expressed as a logarithm, was significantly correlated with the percent of liver resected in all groups. Hepatectomy followed by a maximum total bilirubin of less than 8.5 mg/dl was accepted as safe, and hepatectomy followed by a bilirubin level of 14.4 mg/dl was deemed the maximum permissible resection. On the basis of these results, the safe and permissible limits of hepatectomy in patients with obstructive jaundice were 48.7% and 71.6%, respectively. PE decreased the maximum total bilirubin from 8.5 mg/dl to 3.9 mg/dl when 48.7% of the liver (a safe proportion in all cases) was resected; PE increased the safe limit of hepatectomy from 48.7% to 67.4% when a maximum posthepatectomy total bilirubin level of 8.5 mg/dl was accepted as safe.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Takahashi T,Togo S,Tanaka K,Endo I,Fujii Y,Shimada Hdoi
10.1007/s00268-004-7128-7keywords:
subject
Has Abstractpub_date
2004-05-01 00:00:00pages
475-81issue
5eissn
0364-2313issn
1432-2323journal_volume
28pub_type
杂志文章abstract：BACKGROUND:Laparoscopic reoperative anti-reflux surgery (ARS) has a significantly higher morbidity than laparoscopic primary ARS; however, it is not known whether the same pattern exists within the robotic approach. We aimed to evaluate the safety and efficacy of robotic reoperative ARS in comparison with primary robot...
journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2018-12-01 00:00:00
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2020-05-01 00:00:00
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pub_type： 杂志文章,评审
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pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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更新日期：2001-09-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2001-01-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
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更新日期：2013-03-01 00:00:00
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pub_type： 历史文章,杂志文章
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更新日期：2016-03-01 00:00:00
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pub_type： 杂志文章
doi：10.1007/s00268-015-3207-1
更新日期：2015-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
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更新日期：2013-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-005-0702-9
更新日期：2006-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1995-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 临床试验,杂志文章,随机对照试验
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pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：1996-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2012-04-01 00:00:00
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pub_type： 杂志文章
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更新日期：2010-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2017-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2014-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2003-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-002-6659-z
更新日期：2003-03-01 00:00:00
