| Hepatic steatosis is a risk factor for postoperative complications after major hepatectomy: a matched case-control study. | |
| | |
MedLine Citation:
|
PMID: 17522518 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
OBJECTIVE: To assess the impact of microsteatosis (MiS) and macrosteatosis (MaS) on major hepatectomy. SUMMARY BACKGROUND DATA: While steatosis of a liver graft is an established risk factor in transplantation, its impact on major hepatectomy remains unclear. METHODS: Fifty-eight steatotic patients who underwent major hepatectomy were matched 1:1 with patients with normal liver according to age, gender, ASA score, diagnosis, extent of hepatectomy, and need of hepaticojejunostomy. Steatosis was evaluated quantitatively and qualitatively. Primary endpoints were mortality and complications. RESULTS: Pure MaS and MiS were present in only 10 and 3 patients, respectively, while mixed steatosis was noted in 45 patients. Forty-four patients had mild (10%-30%) and 14 moderate/severe (>30%) steatosis. Steatotic patients had significantly higher serum transaminase and bilirubin levels, and lower prothrombin time. Blood loss (P = 0.04) and transfusions (P = 0.03), and ICU stay (P = 0.001) were increased in steatotic patients. Complications were higher in steatotic patients when considered either overall (50% vs. 25%, P = 0.007) or major (27.5% vs. 6.9%, P = 0.001) complications. Patients with pure MaS had increased mortality (MaS: 20% vs. MiS: 6.6% vs. mixed: 0%; P = 0.36) and major complications (MaS: 66% vs. MiS: 50% vs. mixed: 24%; P = 0.59), but not significantly. Preoperative cholestasis was a highly significant risk factor for mortality in patients with hepatic steatosis. CONCLUSION: Steatosis per se is a risk factor for postoperative complications after major hepatectomy and should be considered in the planning of surgery. Caution must be taken to perform major hepatectomy in steatotic patients with preexisting cholestasis. |
| | |
Authors:
|
Lucas McCormack; Henrik Petrowsky; Wolfram Jochum; Katarzyna Furrer; Pierre-Alain Clavien |
Related Documents
:
|
11235818 - Troglitazone and liver function abnormalities: lessons from a prescription event monito... 21350208 - Restenosis after carotid surgery: the importance of clinical presentation and preoperat... 17444848 - Beneficial effects of pentoxifylline on hepatic steatosis, fibrosis and necroinflammati... 19811438 - Hla-dr allele frequencies in mexican mestizos with autoimmune liver diseases including ... 6227328 - Studies on the phagocytic activity of the granulocytes in psoriasis and palmoplantar pu... 1998308 - Colon interposition for esophageal disease: histologic finding of colonic mucosa after ... |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Annals of surgery Volume: 245 ISSN: 0003-4932 ISO Abbreviation: Ann. Surg. Publication Date: 2007 Jun |
Date Detail:
|
Created Date: 2007-05-24 Completed Date: 2007-07-19 Revised Date: 2009-11-18 |
Medline Journal Info:
|
Nlm Unique ID: 0372354 Medline TA: Ann Surg Country: United States |
Other Details:
|
Languages: eng Pagination: 923-30 Citation Subset: AIM; IM |
Affiliation:
|
Swiss Hepato-Pancreato-Biliary (HPB) Center, Department of Visceral and Transplantation Surgery, University Hospital Zurich, Rämistrasse 100, Zurich, Switzerland. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Case-Control Studies Chi-Square Distribution Fatty Liver / complications* Female Hepatectomy* Humans Liver / pathology Liver Diseases / surgery* Logistic Models Male Middle Aged Postoperative Complications / epidemiology* Prospective Studies Risk Factors Statistics, Nonparametric Treatment Outcome |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Staging of hepatocellular carcinoma: assessment of the Japanese TNM and AJCC/UICC TNM systems in a c...
Next Document: Heme oxygenase-1 induction by the clinically used anesthetic isoflurane protects rat livers from isc...