Avaliação da morbidade e da mortalidade após ressecções hepáticas

Resende, Vívian; Rezende-Neto, João Batista De; Fernandes, Juliana Santana; Cunha-Melo, José Renan

doi:10.1590/s0100-69912011000500007

Cited by 6 publications

(3 citation statements)

References 16 publications

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“…Often, the immediate complications are not reported or, in case they are reported, they are not evenly defined. The literature review resulted in 14 studies about patients subjected to at least 40 liver resections in Brazilian medical services in the past 20 years 3 , 5 , 6 , 9 , 10 , 15 , 17 - 20 , 23 , 24 , 26 .…”

Section: Discussionmentioning

confidence: 99%

Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

Amico

Alves

João

et al. 2016

ABCD, arq. bras. cir. dig.

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Background: Hepatectomies have been increasingly recommended and performed in Brazil; they present great differences related to immediate complications. Aim: Assessing the immediate postoperative complications in a series of 88 open liver resections. Method: Prospective database of patients subjected to consecutive hepatectomies over nine years. The post-hepatectomy complications were categorized according to the Clavien-Dindo classification; complications presenting grade equal to or greater than 3 were considered major complications. Hepatic resections involving three or more resected liver segments were considered major hepatectomies. Results: Eighty-four patients were subjected to 88 hepatectomies, mostly were minor liver resections (50 cases, 56.8%). Most patients had malignant diseases (63 cases; 71.6%). The mean hospitalization time was 10.9 days (4-43). Overall morbidity and mortality rates were 37.5% and 6.8%, respectively. The two most common immediate general complications were intra-peritoneal collections (12.5%) and pleural effusion (12.5%). Bleeding, biliary fistula and liver failure were identified in 6.8%, 4.5% and 1.1% of the cases, respectively, among the hepatectomy-specific complications. Conclusion: The patients operated in the second half of the series showed better results, which were apparently influenced by the increased surgical expertise, by the modification of the hepatic parenchyma section method and by the increased organ preservation.

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Section: Discussionmentioning

confidence: 99%

Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

Amico

Alves

João

et al. 2016

ABCD, arq. bras. cir. dig.

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“…O procedimento, entretanto, deve ser realizado por equipe com experiência em cirurgia hepatobiliopancreática e videolaparoscópica, para dimimuir morbidade e mortalidade 6 . A seleção apropriada dos pacientes e técnica cirúrgica refinada foram primordiais para o sucesso da ressecção hepática laparoscópica, utilizando-se o dispositivo de radiofrequência.…”

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Hepatectomia videolaparoscópica com dispositivo de radiofrequência

Resende

Lima

Lusckal³

et al. 2013

Rev. Col. Bras. Cir.

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As ressecções hepáticas laparoscópicas vêm ganhando adeptos entre cirurgiões pois evidenciam recuperação rápida, menor permanência hospitalar e melhor resultado estético. A utilização do dispositivo laparoscópico de radiofreqüência foi pela primeira vez utilizada, com sucesso, no Brasil, para a ressecção de carcinoma hepatocelular no segmento VI, em dois pacientes cirróticos. Apesar do sangramento intraoperatório continuar sendo um grande desafio para o cirurgião durante ressecções hepáticas laparoscópicas, em ambos os casos, a exclusão vascular hepática foi dispensável e não houve necessidade de hemotransfusão. Os pacientes receberam alta hospitalar no quarto dia pós-operatório.

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“…A recent analysis on 2313 hepatectomies using data from several institutions showed a mortality rate of 2.5% and a morbidity rate of 19.6% 2 . The factors contributing towards this have included better knowledge of hepatic anatomy, development of imaging examinations, better preoperative assessment of patients and their hepatic function, multidisciplinary perioperative work and improvement of operative techniques 17 .…”

Section: Introductionmentioning

confidence: 99%

Hepatectomy: a critical analysis on expansion of the indications

Lopes-Junior

Belebecha

Jacob

2014

ABCD, arq. bras. cir. dig.

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BackgroundHepatic resection has evolved to become safer, thereby making it possible to expand the indications.AimTo assess the results from a group of patients presenting these expanded indications.MethodWere prospectively studied all the hepatectomy procedures performed for hepatic tumor resection. Patients with benign and malignant primary and secondary tumors were included. Were included variables such as age, gender, preoperative diagnosis, preoperative treatment, type of operation performed, need for transfusion, final anatomopathological examination and postoperative evolution. The patients were divided into two groups: group A, with a traditional indication for hepatectomy; and group B, with an expanded indication (tumors in both hepatic lobes, extensive resection encompassing five or more segments, cirrhotic livers and postoperative chemotherapy using hepatotoxic drugs).ResultsWere operated 38 patients, and 40 hepatectomies were performed: 28 patients in group A and 10 in group B. The mean age was 57.7 years, and 25 patients were women. Three in group B were operated as two separate procedures. Groups A and B received means of 1.46 and 5.5 packed red blood cell units per operation, respectively. There were three cases with complications in group A (10.7%) and six in group B (60%). The mortality rate in group A was 3.5% (one patient) and in groups B, 40% (four patients). The imaging examinations were sensitive for the presence of tumors but not for defining the type of tumor. The blood and derivative transfusion rates, morbidity and mortality were greater in the group with expanded indications and more extensive surgery.ConclusionThe indications for liver biopsy and portal vein embolization or ligature can be expanded, with special need of cooperation of the anesthesiology department and the use of hepatic resection devices to diminish blood transfusion.

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Avaliação da morbidade e da mortalidade após ressecções hepáticas

Cited by 6 publications

References 16 publications

Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

Hepatectomia videolaparoscópica com dispositivo de radiofrequência

Hepatectomy: a critical analysis on expansion of the indications

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