Retention of the Right Pleural Effusion after Hepatectomy in Patients with Hepatocellular Carcinoma

Hiroaki Nagano, Yo Sasaki, Shingi Imaoka, Seizo Masutani, Osamu Ishikawa, Hiroaki Ohigashi, Hiroshi Furukawa, Toshiyuki Kabuto, Masahiro Hiratsuka, Masao Kameyama, Hiroki Koyama, Takeshi Iwanaga

Department of Surgery, The Center for Adult Diseases, Osaka

The retention of right pleural effusion after hepatectomy was examined in 115 patients with hepatocellular carcinoma who underwent hepatic resection. Pre- and intra-operative background factors were compared between the patients with and without postoperative pleural effusion. The frequency of patients who had skeltonization of the right hepatic lobe was significantly higher in the former group than in the latter (p<0.01), although no significant differences were recognized between the two groups in most other factors. Among 86 patients with skeletonization of the right hepatic lobe, the value of ICG-R-15 was significantly worse (p<0.05) and the volume of ascites was significantly more (p<0.01) in the effusion-retention group than the non-retantion group. Moreover, the results of biochemical assays of both pleural effusion and ascites were extremely similar in 3 patients with pleural effusion. These results suggested that the retention of right pleural effusion after hepatectomy was caused by the inflow of ascites into the thoracic cavity through a mechanically injured diaphragma, and it occurred more often in patients with poor liver function.

Key words
hepatocellular carcinoma, hepatic resection, pleural effusion after hepatectomy

Reprint requests
Hiroaki Nagano Department of Surgery II, Osaka University Medical School
1-1-50 Fukushima, Fukushima-ku, Osaka, 553 JAPAN

Accepted
September 9, 1992

To read the PDF file you will need Abobe Reader installed on your computer.