| Hepatic resection: an analysis of the impact of operative and perioperative factors on morbidity and mortality rates in 2008 consecutive hepatectomy cases. | |
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MedLine Citation:
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PMID: 20079125 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Hepatectomy is a standard hepatic surgical technique. The safety of hepatectomy has been improved in line with improvements in surgical techniques. This study analyzed the operative and perioperative factors associated with hepatectomy. METHODS: A total of 2008 patients who underwent consecutive hepatectomies between January 1986 and December 2005 were investigated retrospectively. Diagnoses were made based on pathological findings. RESULTS: Malignant and benign liver diseases accounted for 58.5% and 41.2%, respectively, of the conditions requiring resections. Primary liver cancers accounted for 76.1% of the malignant tumors, while hilar cholangiocarcinomas accounted for 6.7%. Hemangiomas (41.7%) and hepatolithiasis (29.6%) were the most common of the benign conditions. Microwave in-line coagulation was used in 236 of our liver resection cases. The overall postoperative complication rate was 14.44%, of which 12.54% of resections were performed for primary liver cancer, 16.40% for secondary liver cancer, and 16.32% for hepatolithiasis. The overall hospital mortality was 0.55%, and that for malignant liver disease was 0.51%. A high mortality (2.53%) was associated with extensive liver resections for hilar cholangiocarcinomas (two deaths in 79 cases). Microwave in-line pre-coagulation resection, Child-Pugh grading, operating time, postoperative length of stay, and preoperative serum albumin level were independent predictors of morbidity. Blood loss, Child-Pugh grading, operating time and preoperative serum albumin level were independent predictors of mortality. CONCLUSIONS: Hepatectomy can be performed safely with low morbidity and mortality, provided that it is carried out with optimal perioperative management and innovative surgical techniques. |
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Authors:
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Zhi-qiang Huang; Li-ning Xu; Tao Yang; Wen-zhi Zhang; Xiao-qiang Huang; Shou-wang Cai; Ai-qun Zhang; Yu-quan Feng; Ning-xin Zhou; Jia-hong Dong |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Chinese medical journal Volume: 122 ISSN: 0366-6999 ISO Abbreviation: Chin. Med. J. Publication Date: 2009 Oct |
Date Detail:
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Created Date: 2010-01-18 Completed Date: 2010-03-17 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7513795 Medline TA: Chin Med J (Engl) Country: China |
Other Details:
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Languages: eng Pagination: 2268-77 Citation Subset: IM |
Affiliation:
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Institute of Hepatobiliary Surgery of PLA, Chinese PLA General Hospital, Beijing 100853, China. wys936602@163.com |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adolescent Adult Aged Aged, 80 and over Child Child, Preschool Female Hepatectomy / adverse effects, mortality* Humans Liver / physiopathology Liver Neoplasms / surgery Male Middle Aged Morbidity Postoperative Complications / etiology |
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