Liver resection morbidity, mortality, and risk factors at the departments of hepatobiliary surgery in Veracruz, Mexico

Martínez-Mier, Gustavo; Esquivel-Torres, S.; Alvarado-Arenas, Rubén; Ortiz-Bayliss, A.B.; Lajud-Barquín, F.A.; Zilli-Hernández, Stefan

doi:10.1016/j.rgmxen.2016.08.002

Cited by 8 publications

(10 citation statements)

References 24 publications

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“…The liver can safely tolerate total vascular occlusion for only approximately 60‐90 minutes under normal temperature via conventional Pringle hepatic inflow occlusion . The blocking time is short but may cause residual liver ischemia, hepatic vein and inferior vena cava bleeding, multiple organ failure, and other complications . Liver transplantation was performed in this patient with total hepatic vascular occlusion at low temperature.…”

Section: Discussionmentioning

confidence: 95%

Ex vivo liver resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: A case report

Shi

Wang

et al. 2018

Pediatric Transplantation

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Some primary and secondary liver carcinomas cannot be resected using a conventional approach due to their size, location, or major vascular invasion. The aim of this study was to explore the application of ex vivo liver resection and autotransplantation for complicated HB in children. A 1.5-year-old girl with HB after repeated chemotherapy was analyzed. In this patient, tumor invasion includes the IV, V, and VIII liver segments, and thrombosis formed in the inferior vena cava and right atrium. It is difficult to obtain complete tumor resection using conventional hepatectomy. The patient was treated via ex vivo liver resection and autotransplantation, and tumor thrombus in the inferior vena cava and right atrium was removed via cardiopulmonary bypass. Operative methods and precautions were analyzed during and after the operation. The operation was completed successfully within 8 hours, and the liver's cold ischemia time was 190 minutes. The patient recuperated successfully, and the liver's function and AFP levels gradually tended to normalize 2 weeks after the operation. Ultrasonic examination revealed that the blood flow velocity of the hepatic vein, portal vein, and hepatic artery was good. The patient recovered and was discharged 3 weeks after the operation. Ex vivo liver resection and autotransplantation have great application value for complicated HB in children that is not suitable for conventional hepatic lobectomy.

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Section: Discussionmentioning

confidence: 95%

Ex vivo liver resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: A case report

Shi

Wang

et al. 2018

Pediatric Transplantation

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“…15 A study from mexico also showed blood loss as a major factor associated with mortality. 16 Kaplan Meier survival curve also showed no significant difference between the two groups. (p=0.227)…”

Section: Discussionmentioning

confidence: 87%

Extrafascial transfissural approach with finger fracture technique approach for liver resection.Old is still gold?

Vasavada

Patel

2020

Preprint

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Background: Background: We evaluated our protocol of extrafascial transfissural approach for liver resection with intrafascial approach that we use in case of donor hepatectomy. Material and Method: We use extrafascial transfissural approach with finger fracture technique for liver resections and inftrafascial approach with clamp crush technique in case of donor hepatectomy. Major hepatectomy defined as resection of 2 or more adjacent segments.We compared these two techniques with regard to blood loss, operative time, morbidity and mortality.We also evaluated over all factors responsible for 90 days mortality.statistical analysis was done using SPSS version 23.(IBM).Categorical factors were evaluated using chi square test and numerical factors were analyzed using Mann Whitney U test. Multivariate analysis was done using logisitic regression method. Ethical approval for our clinical study was obtained by human research COA number SBI 3246. Results: We evaluated 26 liver resections done in last three years. 19 liver resections were done using extrafascial transfissural approach for various liver tumors and 7 living donor hepatectomies were done using itrafascial technique with clamp crush methods. Mean age of patients was 50.73 years.16 patients were males and 10 were females. Mean blood loss was 273.9 ml and mean operative duration was 184.7 minutes. 22 were major resections ,4 were minor liver resections. All minor liver resections were in transfissural approach however there was no statistical significant difference between them. Being live liver doners patients in intrafacial group they were younger than extrafascial transfissural group. (p=0.01). There was no statistical significant difference in blood loss, blood products requirements, morbidity, in hospital and 90 days mortality in both the groups. However extrafascial transfissural with finger fracture technique was associated with significant less operative time. (168.13 minutes vs 222.86 minutes) (p=0.006). 90 days mortality was associated with higher ASA grade (0.018) and blood loss (0.008). However in multivariate analysis no factor indepedently predicted mortality. Conclusion: Extrafascial transfissural approach significantly reduces operative time, without affecting morbidity and mortality in liver resection.

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“…The matter of clips impairing the liver regeneration as foreign objects in the abdominal cavity and inducing immune reactions has not been supported with any evidence. One group suggests the possibility of clips being dislocated by aggressive movements once the mouse recovers from the surgery and anesthesia, which evokes the consideration of different clip sizes [13]. As opposed to the hemostatic clips, suture ligations require adroitness in handling the delicate material.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, liver regeneration remains crucial to enable liver surgery even in advanced tumour stages or in patients with underlying liver diseases. Prediction of the liver insufficiency, a priori would reduce mortality, morbidity, and the hospitalization time [13,14]. In order to comprehend the complex biological, biochemical, and physiological mechanisms behind the regenerating liver, in vitro and in vivo experimental models provide different benefits.…”

Section: Introductionmentioning

confidence: 99%

Extended liver resection in mice: state of the art and pitfalls—a systematic review

Kamali

Brunnbauer

et al. 2021

Eur J Med Res

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Background Rodent models of liver resection have been used to investigate and evaluate the liver’s complex physiology and pathology since 1931. First documented by Higgins and Anderson, such models were created to understand liver regeneration mechanisms to improve outcomes in patients undergoing extensive liver resection for liver cancer or other underlying liver diseases. Methods A systematic search was conducted using Pubmed, gathering publications up to January 2019, which engaged with the mouse model of extended liver resection as a method itself. The results of this search were filtered according to their language, novelty, and relevancy. Results The Boolean search found 3741 articles on Pubmed, with 3130 publications remaining when filtered by language and the presence of a full text. In total, 21 of these publications examined the key themes of the animal model described. The mortality varied from 0 to 50% depending on the surgeon's experience and the resection method. The liver resection was mainly performed with classic sutures (14 out of 21 publications) and isoflurane was used for anaesthesia (10 out of 21 publications) in combination with analgesics (buprenorphine or ketamine/xylazine). The most used mouse strain was C57BL/6 (7 of 21 publications) which was on average 11 weeks old with a weight of 23 g. Conclusion Through the overview, laid out in the selected publications, this paper reviews the shift of the extended liver resection model from rat to the mouse, describes the state of the art in the experimental setting, and discusses the possible limitations and pitfalls. Clearly, the extended liver resection in mice is a reproducible, practical and easy to learn method.

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Liver resection morbidity, mortality, and risk factors at the departments of hepatobiliary surgery in Veracruz, Mexico

Cited by 8 publications

References 24 publications

Ex vivo liver resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: A case report

Ex vivo liver resection and autotransplantation with cardiopulmonary bypass for hepatoblastoma in children: A case report

Extrafascial transfissural approach with finger fracture technique approach for liver resection.Old is still gold?

Extended liver resection in mice: state of the art and pitfalls—a systematic review

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