One Hundred Consecutive Hepatic Resections

Cunningham, John D.; Fong, Yuman; Shriver, Craig D.; Melendez, Jose; Marx, William L.; Blumgart, Leslie H.

doi:10.1001/archsurg.1994.01420340064011

Cited by 248 publications

(59 citation statements)

References 11 publications

(1 reference statement)

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“…Strategies to minimize the risks of allogeneic blood transfusion are leukocyte-depleted transfusions, short storage time and the use of autologous blood transfusion. Methods for autologous transfusion used in liver surgery include preoperative blood donation [19,45,46,47], intraoperative acute normovolemic hemodilution [48], and intraoperative blood salvage [49, 50]. However, these methods are not common clinical practice yet because of logistical reasons in preoperative blood donation or the required training of the operating team in intraoperative hemodilution.…”

Section: Conclusion and Perspectives For The Futurementioning

confidence: 99%

Impact of Blood Loss on Outcome after Liver Resection

Boer¹,

Molenaar²,

Porte³

2007

Dig Surg

139

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Partial liver resections are the treatment of choice for patients with a malignant liver or bile duct tumor. The most frequent indications for partial liver resections are colorectal metastasis, hepatocellular carcinoma (HCC) and cholangiocarcinoma. Liver resection is the only therapy with a chance for cure in these patients. Refinements in surgical technique and increasing experience have contributed to a reduction in perioperative morbidity and mortality in recent years. Despite these improvements, partial liver resections remain a major surgical procedure and carry the risk for excessive blood loss and a subsequent need for blood transfusion. Blood transfusions have been associated with systemic side effects, such as depression of the immune system. Several studies have suggested that perioperative blood loss or transfusions have a negative impact on postoperative outcome. However, it has been debated whether this is due to a real cause-effect relationship or merely the result of more complicated surgery. We have reviewed the literature concerning studies focusing on the relationship between blood loss and blood transfusion during liver surgery for malignant tumors and postoperative outcome. Most studies were based on a retrospective analysis of single center experiences, using uni- and multivariate statistical methods. Most studies have demonstrated a significant and clinically relevant association between blood transfusion and postoperative mortality and morbidity, especially postoperative infectious complications. The effect of blood transfusions on tumor recurrence and more long-term mortality is much less clear and evidence varies depending on the type of malignancy. The strongest indication that blood transfusion may have an impact on tumor recurrence has been found for patients with early stages of HCC. However, overall, no such effect could be demonstrated for patients undergoing partial liver resection for late stages of HCC, colorectal liver metastasis or cholangiocarcinoma.

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Section: Conclusion and Perspectives For The Futurementioning

confidence: 99%

Impact of Blood Loss on Outcome after Liver Resection

Boer¹,

Molenaar²,

Porte³

2007

Dig Surg

139

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“…Despite standardized techniques and technological advancing for liver resections, an intra-operative haemorrhage rate ranging from 700 and 1200 ml is reported with a post-operative morbidity rate ranging from 23 and 46% and a surgical death rate ranging from 4 and 5% [l], [2], [3], [4], [5], [6].…”

Section: Introductionmentioning

confidence: 99%

“…Bleeding has to be considered a major concern for the hepatic surgeon because of several reasons. At first it is certainly the major intraoperative surgical complication and cause of death and historically one of the major postoperative complication together with bile leaks and hepatic failure [5], [6], [7], [8], [9].…”

Section: Introductionmentioning

confidence: 99%

The Aim of Technology During Liver Resection — A Strategy to Minimize Blood Loss During Liver Surgery

Romano¹,

Garancini²,

Uggeri³

et al. 2013

Hepatic Surgery

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“…On the contrary, there are also large series in which fewer than 10% of patients received transfusions [4,5,6,7]. In addition to the inherent difficulties in adequately replacing blood components in cases of severe bleeding, allogeneic blood transfusion constitutes a risk factor for intra- and postoperative morbidity, including transmission of viral disease, transfusion reactions and, in case of malignant disease, the controversial adverse effect of blood transfusion on tumor recurrence [8, 9].…”

Section: Introductionmentioning

confidence: 99%

Use of Topical Hemostatic Agents during Liver Resection

Berrevoet

Hemptinne²

2007

Dig Surg

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Despite all recent developments in surgical techniques during liver surgery, blood loss is still one of the main causes for postoperative morbidity and mortality. Other complications include bile leakage and fluid accumulation intraperitoneally. Fibrin sealants are able not only to enhance clot formation and wound healing but possibly work as a sealing device for postoperative leakage and fistula formation. In this overview the underlying mechanisms for these agents are discussed and several clinical data concerning liver surgery will be reported.

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One Hundred Consecutive Hepatic Resections

Abstract: The surgical techniques used results in acceptable blood loss and transfusion requirements for hepatic resection. This approach is safe, cost-effective, reproducible, and applicable for widespread use.

Cited by 248 publications

References 11 publications

Impact of Blood Loss on Outcome after Liver Resection

Impact of Blood Loss on Outcome after Liver Resection

The Aim of Technology During Liver Resection — A Strategy to Minimize Blood Loss During Liver Surgery

Use of Topical Hemostatic Agents during Liver Resection

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