Shan Jin, Gerile Wuyun, Tu Wuyun, Department of General Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China.
World J Gastroenterol. 2013 Nov 28;19(44):7983-91. doi: 10.3748/wjg.v19.i44.7983.
Hepatic resection had an impressive growth over time. It has been widely performed for the treatment of various liver diseases, such as malignant tumors, benign tumors, calculi in the intrahepatic ducts, hydatid disease, and abscesses. Management of hepatic resection is challenging. Despite technical advances and high experience of liver resection of specialized centers, it is still burdened by relatively high rates of postoperative morbidity and mortality. Especially, complex resections are being increasingly performed in high risk and older patient population. Operation on the liver is especially challenging because of its unique anatomic architecture and because of its vital functions. Common post-hepatectomy complications include venous catheter-related infection, pleural effusion, incisional infection, pulmonary atelectasis or infection, ascites, subphrenic infection, urinary tract infection, intraperitoneal hemorrhage, gastrointestinal tract bleeding, biliary tract hemorrhage, coagulation disorders, bile leakage, and liver failure. These problems are closely related to surgical manipulations, anesthesia, preoperative evaluation and preparation, and postoperative observation and management. The safety profile of hepatectomy probably can be improved if the surgeons and medical staff involved have comprehensive knowledge of the expected complications and expertise in their management. This review article focuses on the major postoperative issues after hepatic resection and presents the current management.
肝切除术的发展令人瞩目。它已广泛应用于治疗各种肝脏疾病，如恶性肿瘤、良性肿瘤、肝内胆管结石、包虫病和脓肿。肝切除术的管理具有挑战性。尽管技术进步和专门中心的肝切除术经验丰富，但它仍然存在较高的术后发病率和死亡率。特别是，在高危和老年患者人群中，复杂的切除术越来越多。由于肝脏独特的解剖结构和重要的功能，肝脏手术尤其具有挑战性。常见的肝切除术后并发症包括静脉导管相关感染、胸腔积液、切口感染、肺不张或感染、腹水、膈下感染、尿路感染、腹腔内出血、胃肠道出血、胆道出血、凝血障碍、胆漏和肝功能衰竭。这些问题与手术操作、麻醉、术前评估和准备以及术后观察和管理密切相关。如果参与手术的外科医生和医务人员对预期的并发症有全面的了解，并具备管理这些并发症的专业知识，肝切除术的安全性可能会得到提高。本文重点介绍肝切除术后的主要术后问题，并介绍当前的管理方法。
