Characteristic risk factors in cirrhotic patients for posthepatectomy complications: Comparison with noncirrhotic patients

Shinji Itoh, Hideaki Uchiyama, Hirofumi Kawanaka, Takahiro Higashi, Akinori Egashira, Daihiko Eguchi, Toshiro Okuyama, Masahiro Tateishi, Daisuke Korenaga, Kenji Takenaka

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Abstract

There seemed to be characteristic risk factors in cirrhotic patients for posthepatectomy complications because these patients have less hepatic reserve as compared with noncirrhotic patients. The aim of the current study was to identify these characteristic risk factors in cirrhotic patients. We performed 419 primary hepatectomies for hepatocellular carcinoma. The patients were divided into the cirrhotic group (n 5 198) and the noncirrhotic group (n 5 221), and the risk factors for posthepatectomy complications were compared between the groups. Thirty-six cirrhotic patients (18.2%) experienced Clavien's Grade III or more complications. Tumor size, intraoperative blood loss, duration of operation, major hepatectomy (two or more segments), and necessity of blood transfusion were found to be significant risk factors in univariate analyses. Multivariate analysis revealed that major hepatectomy and intraoperative blood loss were independent risk factors for posthepatectomy complications in patients with cirrhosis. On the other hand, the duration of operation was only an independent risk factor for posthepatectomy complication in noncirrhotic patients. Cirrhotic patients should avoid a major hepatectomy and undergo a limited resection preserving as much liver tissue as possible and meticulous surgical procedures to lessen intraoperative blood loss are mandatory to prevent major posthepatectomy complications.

Original languageEnglish
Pages (from-to)166-170
Number of pages5
JournalAmerican Surgeon
Volume80
Issue number2
Publication statusPublished - Feb 1 2014
Externally publishedYes

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All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

Itoh, S., Uchiyama, H., Kawanaka, H., Higashi, T., Egashira, A., Eguchi, D., ... Takenaka, K. (2014). Characteristic risk factors in cirrhotic patients for posthepatectomy complications: Comparison with noncirrhotic patients. American Surgeon, 80(2), 166-170.