Timing and Risk Factors of Hepatectomy in the Management of Complications Following Laparoscopic Cholecystectomy.

15:13 EDT 3rd September 2015 | BioPortfolio

Summary of "Timing and Risk Factors of Hepatectomy in the Management of Complications Following Laparoscopic Cholecystectomy."


INTRODUCTION:
Complex bile duct injury (BDI) is a serious condition requiring hepatectomy in some instances. The present study was to analyse the factors that led to hepatectomy for patients with BDI after laparoscopic cholecystectomy (LC).
METHODS:
The medical records of patients referred to our department from April 1998 to September 2007 for management of BDI following LC were reviewed, and patients who underwent hepatectomy were identified. The type of BDI, indication for liver resection, interval between LC and liver surgery, histology of the liver specimen, postoperative morbidity and long-term results were analysed.
RESULTS:
Hepatectomy was performed in 10 of 76 patients (13.2%), with BDI either as isolated damage or in combination with vascular injury (VI). Proximal BDI (defined as disruption of the biliary confluence) and injury to the right hepatic artery were found to be independent risk factors of hepatectomy, with odds ratios of 16 and 45, respectively. Five patients required early liver resection (within 5 weeks post-LC) to control sepsis caused by confluent liver necrosis or bile duct necrosis. In five patients, hepatectomy was indicated during long-term follow-up (over 4 months post-LC) to effectively manage recurrent cholangitis and liver atrophy. Despite of high postoperative morbidity (60%) and even mortality (10%), the long-term results (median follow-up of 34 months) were satisfactory, with either no or only transitory symptoms in 67% of the patients.
CONCLUSION:
Hepatectomy may inevitably be necessary to manage early or late complications after LC. Proximal BDI and VI were the two independent risk factors of hepatectomy in this series.

Affiliation

Department of General, Visceral and Transplantation Surgery, University Hospital Tübingen, Tübingen, Germany, jun.li@med.uni-tuebingen.de.

Journal Details

This article was published in the following journal.

Name: Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract
ISSN: 1873-4626
Pages:

Links

PubMed Articles [27240 Associated PubMed Articles listed on BioPortfolio]

Risk factors for complications after laparoscopic major hepatectomy.

Although laparoscopic major hepatectomy (MH) is becoming increasingly common in several specialized centres, data regarding outcomes are limited. The aim of this study was to identify the risk factors...

Laparoscopy Decreases Pulmonary Complications in Patients Undergoing Major Liver Resection: A Propensity Score Analysis.

To compare both incidence and types of postoperative pulmonary complications (PPCs) between laparoscopic major hepatectomy (LMH) and open major hepatectomy (OMH).

Detecting performance variance in complex surgical procedures: analysis of a step-wise technique for laparoscopic right hepatectomy.

Laparoscopic right hepatectomy (LRH) is a technically challenging operation. Our aim is to evaluate a standardized technique of LRH and determine variances in performance.

Avoiding Complications in Endoscopic Sinus Surgery.

Complications of endoscopic sinus surgery (ESS) can range from the mundane to the catastrophic, with nasal hemorrhage being the most common. Intraorbital and intracranial complications are much less c...

An Evaluation of the Safety of Pure Laparoscopic Hepatectomy in Patients With Liver Cirrhosis: Investigations Including Serum Albumin and Ascites.

The purpose of this study was to investigate scientific advantages and safety of pure laparoscopic hepatectomy in patients with severe damaged liver and cirrhosis.

Clinical Trials [5802 Associated Clinical Trials listed on BioPortfolio]

Laparoscopic Surgery Versus Radiofrequency Ablation for Recurrent HCC

Hepatocellular carcinoma (HCC) is the fifth most common and the third leading cause of death from cancer worldwide1 . Hepatectomy is still the main effective treatment for HCC accompanying...

Laparoscopic Versus Open Liver Resection for Hepatocellular Carcinoma

The purpose of the study is to observe the curative effect and safety of laparoscopic versus open liver resection for hepatocellular carcinoma.

Risk Factors for Shoulder Pain and Emesis After Laparoscopic Cholecystectomy

Risk factors for postoperative shoulder pain after laparoscopic cholecystectomy were not clear. Moreover, risk factors for postoperative emesis specially for this surgery were not detailed...

Enhanced Recovery After Surgery Protocal Versus Traditional Care in Laparoscopic Hepatectomy

The purpose of this study is to investigate the clinical value of enhanced recovery after surgery protocal in laparoscopic hepatectomy by assessing its outcomes and hospital stay days comp...

P6 Acupressure Before Laparoscopic Cholecystectomy

This study is to evaluate the effect of preoperative acupressure application on Postoperative nausea and vomiting (PONV) in patients undergoing laparoscopic cholecystectomy in terms of be...

Medical and Biotech [MESH] Definitions

The process of minimizing risk to an organization by developing systems to identify and analyze potential hazards to prevent accidents, injuries, and other adverse occurrences, and by attempting to handle events and incidents which do occur in such a manner that their effect and cost are minimized. Effective risk management has its greatest benefits in application to insurance in order to avert or minimize financial liability. (From Slee & Slee: Health care terms, 2d ed)

The relating of causes to the effects they produce. Causes are termed necessary when they must always precede an effect and sufficient when they initiate or produce an effect. Any of several factors may be associated with the potential disease causation or outcome, including predisposing factors, enabling factors, precipitating factors, reinforcing factors, and risk factors.

Factors that can cause or prevent the outcome of interest, are not intermediate variables, and are not associated with the factor(s) under investigation. They give rise to situations in which the effects of two processes are not separated, or the contribution of causal factors cannot be separated, or the measure of the effect of exposure or risk is distorted because of its association with other factors influencing the outcome of the study.

Complications that affect patients during surgery. They may or may not be associated with the disease for which the surgery is done, or within the same surgical procedure.

Excision of all or part of the liver. (Dorland, 28th ed)


Advertisement
 

Relevant Topics

Hepatology
Latest News Clinical Trials Research Drugs Reports Corporate
Hepatology is the study of liver, gallbladder, biliary tree, and pancreas, and diseases associated with them. This includes viral hepatitis, alcohol damage, cirrhosis and cancer. As modern lifestyles change, with alcoholism and cancer becoming more promi...

Blood
Latest News Clinical Trials Research Drugs Reports Corporate
Blood is a specialized bodily fluid that delivers necessary substances to the body's cells (in animals) – such as nutrients and oxygen – and transports waste products away from those same cells.  In vertebrates, it is composed of blo...

Advertisement
 

Searches Linking to this Article