Complications after Hepatic Resection and its Care

Yoshiro Matsumoto

The First Department of Surgery, Yamanashi Medical University

Complications following hepatic resection and their care were studied. Indications for the procedure are primary liver cancer, benign liver tumor, bile duct cancer of the hepatic hilum, gallbladder cancer and primary intrahepatic stone. There is a high incidence of the complications in patients with chronic liver disease (LC) who underwent hepatic resection, and in those who did hepatic resection of more than one segment, accompanied by pancreatoduodenectomy. The complications in the patients with LC are mainly fluid collection, bule leakage, and abscess formation at the resection edge of the liver, and following hepatic failure. Primarily, effective drainage from the edge is the most important procedure for care of the complications. With regard to postoperative complications of hepato-pancreatoduodenectomy, hepatic failure, leakage of the pancreatojejunal anastomosis and intraabdominal infection are the chief complications. The mortality of the patients undergoing hepatic resection of more than 2 segments is reported to be from 33% to 47%. Although the pathogenesis of the complications in these patients is not clear, we suspect that the catabolic phase after their surgery is prolonged and in the prolonged phase, massive bleeding, infection and hemodynamic changes can easily cause the complications.

Key words
hepatic farilure, intraabdominal abscess, hepato-pancreatoduodenectomy

Reprint requests
Yoshiro Matsumoto The First Department of Surgery, Yamanashi Medical University
1110 Shimokato, Tomahocho, Nakakamagun, Yamanashi, 409-38 JAPAN

Accepted
November 15, 1995

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