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肝切除术后外周血单核细胞计数与结直肠肝转移患者术后胆漏相关。

Postoperative peripheral blood monocyte count correlates with postoperative bile leakage in patients with colorectal liver metastases after hepatic resection.

机构信息

Department of Surgery, The Jikei University School of Medicine, 3-25-8, Nishi-Shinbashi, Minato-ku, Tokyo 105-8461, Japan.

出版信息

Langenbecks Arch Surg. 2013 Aug;398(6):851-5. doi: 10.1007/s00423-013-1083-4. Epub 2013 May 3.

Abstract

PURPOSE

Postoperative bile leakage is one of the most common complications after hepatic surgery. The relationship between the inflammatory response and postoperative bile leakage has not been fully investigated. Therefore, we retrospectively investigated the relation between postoperative peripheral blood monocyte count and bile leakage in patients with colorectal liver metastases (CRLM) after elective hepatic resection.

METHODS

The study comprised 105 patients who had undergone hepatic resection for CRLM between January 2000 and March 2012. Perioperative risk factors pertinent to development of bile leakage were investigated using univariate and multivariate analyses.

RESULTS

Bile leakage developed in 9 (8.6 %) of 105 patients. In multivariate analysis, intraoperative fresh frozen plasma (FFP) transfusion (p = 0.009) and lower monocyte count of the peripheral blood on postoperative day 1 (p = 0.038) were found as independent risk factors of bile leakage.

CONCLUSIONS

Postoperative lower monocyte count and intraoperative FFP transfusion were associated with the development of postoperative bile leakage after elective hepatic resection in patients with CRLM.

摘要

目的

术后胆漏是肝手术后最常见的并发症之一。炎症反应与术后胆漏之间的关系尚未得到充分研究。因此,我们回顾性研究了选择性肝切除术后结直肠癌肝转移(CRLM)患者术后外周血单核细胞计数与胆漏之间的关系。

方法

本研究纳入了 2000 年 1 月至 2012 年 3 月期间因 CRLM 接受肝切除术的 105 例患者。使用单因素和多因素分析研究与胆漏发生相关的围手术期危险因素。

结果

105 例患者中有 9 例(8.6%)发生胆漏。多因素分析显示,术中新鲜冷冻血浆(FFP)输注(p=0.009)和术后第 1 天外周血单核细胞计数较低(p=0.038)是胆漏的独立危险因素。

结论

术后外周血单核细胞计数降低和术中 FFP 输注与 CRLM 患者选择性肝切除术后术后胆漏的发生有关。

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