Department of Surgery I, Faculty of Medicine, Oita University, Hasama-machi, Yufu, Japan.
Am J Surg. 2013 Sep;206(3):374-9. doi: 10.1016/j.amjsurg.2012.12.013. Epub 2013 Jul 5.
To prevent hepatic failure after major hepatectomy, it is important to assess preoperative factors related to liver failure.
We examined 80 patients who underwent right-sided hepatectomy. Hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay were defined as liver failure after hepatectomy, and these 3 factors were evaluated in relation to clinicopathological and surgical factors.
In the 80 patients, hyperbilirubinemia was observed in 10 (12.7%) patients, uncontrolled ascites in 18 (22.5%) patients, and prolonged hospital stay after surgery in 39 (48.8%) patients. Multivariate analyses identified platelet count as a risk factor of hyperbilirubinemia, uncontrolled ascites, and prolonged postoperative hospital stay, and the ratio of remnant liver volume to body surface area (RLV/BSA ratio) as an additional risk factor of hyperbilirubinemia and prolonged postoperative hospital stay.
Platelet count and RLV/BSA ratio are useful risk factors for prediction of liver failure after right-sided hepatectomy.
为了预防重大肝切除术后肝衰竭，评估与肝功能衰竭相关的术前因素非常重要。
我们检查了 80 例行右半肝切除术的患者。将术后发生高胆红素血症、腹水难以控制和术后住院时间延长定义为肝切除术后肝功能衰竭，并评估了这 3 个因素与临床病理和手术因素的关系。
在 80 例患者中，10 例（12.7%）患者出现高胆红素血症，18 例（22.5%）患者出现腹水难以控制，39 例（48.8%）患者术后住院时间延长。多变量分析确定血小板计数是高胆红素血症、腹水难以控制和术后住院时间延长的危险因素，而剩余肝体积与体表面积比（RLV/BSA 比）是高胆红素血症和术后住院时间延长的附加危险因素。
血小板计数和 RLV/BSA 比是预测右半肝切除术后肝功能衰竭的有用危险因素。
