HEPATO-GASTROENTEROLOGY 59, 118, 1915 - 1920 (2012).
Safety of Hepatectomy Accompanying Combined Resection of other Organs
Atsushi Nanashima , Takafumi Abo , Hiroaki Takeshita , Naoya Yamasaki , Terumitsu Sawai , Takeshi Nagayasu
Background/Aims: The present study analyzed post-operative outcomes for patients who underwent hepatectomy accompanied by resection of other organs, to clarify operative safety. Methodology: We examined perioperative parameters in 95 patients who underwent hepatectomy and other organ resections (colorectal resection, n=46; gastrectomy or duodenectomy, n=13; splenectomy, n=17; resection of diaphragm, n=9; pulmonary resection, n=4; others, n=6). Results: Prevalence of chronic liver dysfunction (100%) or hepatocellular carcinoma (HCC) (100%) was significantly higher in patients who underwent splenectomy than in other groups (17% and 21%, respectively; p<0.01). Extent of hepatectomy, operating time and blood loss did not differ significantly between groups. Frequency of blood transfusion use was highest in patients who underwent splenectomy (p<0.01). Postoperative complications tended to be more frequent among patients who underwent splenectomy, but this difference was not significant. Wound infection tended to be more frequent among patients who underwent colorectal resection, but not significantly (p=0.11). Hepatectomy associated complications in patients who underwent splenectomy most often appeared in the form of uncontrolled ascites (p<0.01), with hospital deaths rarely observed and hospital stay not significantly different between groups. Conclusions: Good postoperative outcomes in multi-organ resections with hepatectomy were observed by careful perioperative management based on adequate indications for hepatectomy.