Kar Irfan, Qayum Kaif, Sofi Junaid
General Surgery, Wye Valley NHS Foundation Trust, Hereford, GBR.
General Surgery, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, IND.
Cureus. 2021 Nov 18;13(11):e19713. doi: 10.7759/cureus.19713. eCollection 2021 Nov.
This study aimed to determine the indications and demographic profile of hepatic resection at Sher-I-Kashmir Institute of Medical Sciences (SKIMS), the performed types of hepatic resection, as well as assess the details of the operation and perioperative complications of hepatic resection.
This is a prospective, retrospective observational study. The retrospective study period was from January 2005 to August 2015 and the prospective study period was from 2015 till 2017. Prospective patients were clinically evaluated by medical history and clinical examination and also underwent various investigations. The patients were scored on Child-Pugh and American Society of Anesthesiology (ASA) scores for risk stratification and prepared for surgery, which included segmentectomy to major liver resection. The retrospective data were obtained from the Medical Records Department (MRD). Statistical analysis was done on SPSS software 25.0 version (Armonk, NY: IBM Corp.).
This study included 122 patients with a male to female ratio of 1:1.59. The patients' age was between 1 and 73 years. The patients' most common complaint was right upper quadrant abdominal pain. The main established clinical diagnosis was oriental cholangiohepatitis (OCH) (36.9%) followed by carcinoma of gallbladder (CaGB) which accounted for 37 cases (30.4%). Liver metastases including solitary masses and multiple lesions were 10 cases (8.2%). Fifty-five patients underwent left lateral segmentectomy (45.1%) and mostly for OCH. Standard wedge resection was done in 30.7% of cases and for all cases of CaGB. The mean blood loss was 146.5 ml. A total of 37 patients had complications. Wound infection was the most common complication, occurring in 10 patients (8.2%).
Patients with hepatobiliary pathology, necessitating liver resection are now routinely admitted to the Department of Surgical Gastroenterology in SKIMS, Srinagar. Patients are carefully evaluated and operated with a confirmed definitive diagnosis. The overall surgical outcome does not differ from India's best centers.
本研究旨在确定斯利那加谢赫-克什米尔医学科学研究所（SKIMS）肝切除术的适应症和人口统计学特征、所施行的肝切除类型，并评估肝切除手术细节及围手术期并发症。
这是一项前瞻性、回顾性观察研究。回顾性研究时间段为2005年1月至2015年8月，前瞻性研究时间段为2015年至2017年。前瞻性患者通过病史和临床检查进行临床评估，并接受各种检查。根据Child-Pugh评分和美国麻醉医师协会（ASA）评分对患者进行风险分层，为包括肝段切除术至 major liver resection（此处原文有误，可能是major liver resection，可译为“大范围肝切除术”）在内的手术做准备。回顾性数据从病历科（MRD）获取。使用SPSS 25.0版软件（纽约州阿蒙克：IBM公司）进行统计分析。
本研究纳入122例患者，男女比例为1:1.59。患者年龄在1岁至73岁之间。患者最常见的主诉是右上腹疼痛。主要确诊的临床诊断为东方胆管肝炎（OCH）（36.9%），其次是胆囊癌（CaGB），占37例（30.4%）。包括孤立肿块和多发病变的肝转移瘤有10例（8.2%）。55例患者接受了左外侧肝段切除术（45.1%），主要是因OCH。30.7%的病例进行了标准楔形切除术，所有CaGB病例均进行了该手术。平均失血量为146.5毫升。共有37例患者出现并发症。伤口感染是最常见的并发症，10例患者（8.2%）发生。
需要进行肝切除的肝胆疾病患者现在常规入住斯利那加SKIMS的外科胃肠病科。患者经过仔细评估，并在确诊后进行手术。总体手术结果与印度最好的中心无异。
