Abstract:
BACKGROUND/PURPOSE:The purpose of this study was to identify risk factors for major morbidity after hepatectomies for hepatocellular carcinoma (HCC). METHODS:Univariate and multivariate analyses of risk factors for major morbidity were performed in 293 patients who underwent hepatectomy for HCC between 2001 and 2008. RESULTS:Two hundred and forty-three patients (82.9%) underwent an anatomic hepatectomy, and a repeat hepatectomy was performed in 50 patients (17.1%). The prevalences of bile leakage and intraabdominal abscess were 12.9% and 9.2%, respectively. The risk factor for bile leakage was an operative time >or= 300 min and the risk factor for intraabdominal abscess was a repeat hepatectomy (odds ratios = 4.9 and 5.3, respectively). The main cause of bile leakage that made endoscopic therapy or percutaneous transhepatic biliary drainage necessary was a latent stricture of the biliary anatomy that had existed preoperatively, caused by previous treatments for HCC. Methicillin-resistant Staphylococcus aureus was the main causative bacteria of intraabdominal abscess after repeat hepatectomies. CONCLUSIONS:Our recent series revealed that prolonged operative time and repeat hepatectomy were independent risk factors for bile leakage and intraabdominal abscess, respectively, after hepatectomies for HCC. Preoperative assessment of the biliary anatomy should be considered for patients who have had previous multiple treatments for HCC, including hepatectomy, to reduce bile leakage that makes invasive treatment necessary.
journal_name
J Hepatobiliary Pancreat Scijournal_title
Journal of hepato-biliary-pancreatic sciencesauthors
Sadamori H,Yagi T,Matsuda H,Shinoura S,Umeda Y,Yoshida R,Satoh D,Utsumi T,Ohnishi Tdoi
10.1007/s00534-010-0275-3subject
Has Abstractpub_date
2010-09-01 00:00:00pages
709-18issue
5eissn
1868-6974issn
1868-6982journal_volume
17pub_type
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journal_title:Journal of hepato-biliary-pancreatic sciences
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journal_title:Journal of hepato-biliary-pancreatic sciences
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journal_title:Journal of hepato-biliary-pancreatic sciences
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pub_type: 杂志文章,多中心研究
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journal_title:Journal of hepato-biliary-pancreatic sciences
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更新日期:2015-05-01 00:00:00
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journal_title:Journal of hepato-biliary-pancreatic sciences
pub_type: 评论,杂志文章
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