Immediate Complications After 88 Hepatectomies - Brazilian Consecutive Series

Abstract

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.

Liver Resections for Metastasis: Surgical Outcomes of a Single Center Academic Institution

“…Our study presented an overall rate of postoperative complications of 11.6%, even including a large percentage of major LRs (79.6%) -higher than the percentages found in other Brazilian series, with 31.4% and 43.2% (15,16). Considering that the complication rates have progressive increase according to the extent of LR, these values are in line with those found in literature (8).…”

“…The surgical outcomes of LRs are also described in other studies, such as Resende et al, which showed a rate of postoperative complications of 11.4%, including non-oncologic cases (16). Other authors such as Amico et al show complication rates of 14.7%, highlighting intraperitoneal collection, pleural effusion and hemorrhage (15). In both national studies there was a higher rate of postoperative complications in patients undergoing major LRs.…”

“…Improved surgical technique and better knowledge of the physiological anatomy of the liver, combined with better diagnostic conditions, allowed LR to be performed more often in oncologic patients (15).…”

Functional and Cellular Evaluation of the Liver After Low-Power Laser Stimulation During Surgery

“…The ALT and AST aminotransferases in the presence of hepatocyte membrane damage are released in large amounts into the bloodstream, observing elevated levels of ALT and AST 8 , 19 . The studies performed by Araujo Lima et al 2 and Monteiro 17 , both with hepatectomized cirrhotic Wistar rats, demonstrated that liver function tests remain within normal limits. In this study, all groups presented mean AST values, lower than the reference values ​​in the literature (39-92 U/l) 27 , but were not statistically significant when compared to each other.…”

“…Studies that observe liver function through liver function tests, through analysis of serum levels of aminotransferases, gamma glutamyltransferase, alkaline phosphatase and bilirubin, show that the use of TLBP in the hepatic regeneration process does not cause liver damage in addition to the surgical procedure on livers of healthy rats 2 , 17 , 20 , 21 .…”