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无腹腔引流的肝切除术。61例患者的前瞻性研究结果。

Hepatectomy without abdominal drainage. Results of a prospective study in 61 patients.

作者信息

Franco D, Karaa A, Meakins J L, Borgonovo G, Smadja C, Grange D

机构信息

Groupe de Recherche sur la Chirurgie du Foie et de l'Hypertension Portale, Université Paris XI, Hôpital Louise Michel, Evry, France.

出版信息

Ann Surg. 1989 Dec;210(6):748-50. doi: 10.1097/00000658-198912000-00009.

Abstract

The increasingly simple postoperative course of major surgery has challenged the routine use of drainage after most abdominal surgical procedures. Therefore a prospective study was designed to determine if abdominal drainage could be safely avoided after liver resection and was evaluated in 61 consecutive patients. There was one postoperative death (1.7%) from variceal bleeding. Four other patients (6.7%) developed an abdominal complication: two right subphrenic hematomas requiring reoperation in one case and two incisional ascitic leaks requiring incisional repair in one patient. There was neither a subphrenic abscess nor bile peritonitis. Postoperative hospitalization was 11.5 +/- 3 days in the entire group and 8.5 +/- 1 days in patients without complications. These results suggest that liver resection can be performed safely without abdominal drainage and that the routine use of drains is unnecessary.

摘要

大多数腹部外科手术后,大手术术后过程日益简化,这对常规放置引流管提出了挑战。因此,设计了一项前瞻性研究,以确定肝切除术后是否可以安全地不放置腹腔引流管,并对61例连续患者进行了评估。有1例(1.7%)患者术后因静脉曲张破裂出血死亡。另外4例(6.7%)患者出现腹部并发症:2例右膈下血肿,其中1例需要再次手术;2例切口腹水渗漏,其中1例需要进行切口修复。未发生膈下脓肿和胆汁性腹膜炎。全组患者术后住院时间为11.5±3天,无并发症患者为8.5±1天。这些结果表明,肝切除可不放置腹腔引流管安全进行,常规放置引流管并无必要。

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本文引用的文献

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