Amico Enio Campos, Alves José Roberto, João Samir Assi, Guimarães Priscila Luana Franco Costa, Medeiros Joafran Alexandre Costa de, Barreto Élio José Silveira da Silva
University Hospital Onofre Lopes, Federal University of Rio Grande do Norte, Natal, RN, Brazil.
Arq Bras Cir Dig. 2016 Jul-Sep;29(3):180-184. doi: 10.1590/0102-6720201600030012.
Hepatectomies have been increasingly recommended and performed in Brazil; they present great differences related to immediate complications.
Assessing the immediate postoperative complications in a series of 88 open liver resections.
Prospective database of patients subjected to consecutive hepatectomies over nine years. The post-hepatectomy complications were categorized according to the Clavien-Dindo classification; complications presenting grade equal to or greater than 3 were considered major complications. Hepatic resections involving three or more resected liver segments were considered major hepatectomies.
Eighty-four patients were subjected to 88 hepatectomies, mostly were minor liver resections (50 cases, 56.8%). Most patients had malignant diseases (63 cases; 71.6%). The mean hospitalization time was 10.9 days (4-43). Overall morbidity and mortality rates were 37.5% and 6.8%, respectively. The two most common immediate general complications were intra-peritoneal collections (12.5%) and pleural effusion (12.5%). Bleeding, biliary fistula and liver failure were identified in 6.8%, 4.5% and 1.1% of the cases, respectively, among the hepatectomy-specific complications.
The patients operated in the second half of the series showed better results, which were apparently influenced by the increased surgical expertise, by the modification of the hepatic parenchyma section method and by the increased organ preservation.
在巴西，肝切除术的推荐和实施越来越多；其在直接并发症方面存在很大差异。
评估88例开放性肝切除术患者的术后即刻并发症。
对9年间连续接受肝切除术的患者建立前瞻性数据库。肝切除术后并发症根据Clavien-Dindo分类进行归类；3级及以上的并发症被视为主要并发症。涉及三个或更多肝段切除的肝切除术被视为大肝切除术。
84例患者接受了88次肝切除术，大部分为小肝切除术（50例，56.8%）。大多数患者患有恶性疾病（63例；71.6%）。平均住院时间为10.9天（4 - 43天）。总体发病率和死亡率分别为37.5%和6.8%。最常见的两种即刻全身并发症是腹腔积液（12.5%）和胸腔积液（12.5%）。在肝切除特异性并发症中，出血、胆瘘和肝衰竭的发生率分别为6.8%、4.5%和1.1%。
该系列后半期接受手术的患者结果更好，这显然受到手术专业技能提高、肝实质切断方法的改进以及器官保留增加的影响。
