Garcia Fernanda Oliveira Barreto, Garcia Rafael José Romero, Maurity Mariana Pereira, Nascimento Erica Samara Monteiro
Fundação Santa Casa de Misericórdia do Pará - Belém (PA), Brazil.
Universidade Federal do Pará - Belém (PA), Brazil.
Arq Bras Cir Dig. 2024 Dec 16;37:e1845. doi: 10.1590/0102-6720202400051e1845. eCollection 2024.
Hepatectomy is historically associated with higher morbidity and mortality, related to intraoperative blood loss and biliary fistulas. Technological advances and improvements in surgical and anesthetic techniques have led to greater safety in performing these surgeries.
The aim of this study was to analyze morbidity and mortality in patients undergoing hepatectomy.
Retrospective cohort study of patients undergoing liver resections. The type of hepatectomy, indications, need for intraoperative blood transfusion, hospital stay, complications, and postoperative mortality were analyzed.
A total of 48 hepatectomies were performed during the studied period, the most common being 26 (54.16%) major hepatectomies, distributed among 13 (50%) left hepatectomies, 11 (42.30%) right hepatectomies, and 2 (7.70%) others. In total, 24 (45.84%) minor hepatectomies were performed, 11 (50%) mono segmentectomies, and 5 (22.72%) left lateral hepatectomies. The main indications for resection in benign diseases were 6 (12.50%) neotropical hepatic hydatidosis, five (10.41%) intrahepatic lithiasis, and in primary malignancies, 9 (18.75%) hepatocarcinomas. There was no need for an intraoperative blood transfusion. Hospital stays after surgery ranged from 2 to 40 days (average=7 days), and 41 (85.42%) patients went to the ICU in the first 72 h after surgery. In total, 9 (18.75%) patients developed postoperative complications. Overall mortality was 2.08%.
Hepatocellular carcinoma and neotropical hydatidosis were the main diseases with surgical indication, and major hepatectomies were the most performed procedures. Morbidity and mortality were in line with results from major global centers.
从历史上看，肝切除术与较高的发病率和死亡率相关，这与术中失血和胆瘘有关。技术进步以及手术和麻醉技术的改进使得这些手术的安全性更高。
本研究的目的是分析接受肝切除术患者的发病率和死亡率。
对接受肝脏切除术的患者进行回顾性队列研究。分析肝切除术的类型、适应证、术中输血需求、住院时间、并发症和术后死亡率。
在研究期间共进行了48例肝切除术，最常见的是26例（54.16%）大肝切除术，分布在13例（50%）左肝切除术、11例（42.30%）右肝切除术和2例（7.70%）其他类型中。总共进行了24例（45.84%）小肝切除术，11例（50%）单段肝切除术和5例（22.72%）左外侧肝切除术。良性疾病切除的主要适应证为6例（12.50%）热带肝包虫病、5例（10.41%）肝内结石，原发性恶性肿瘤中9例（18.75%）为肝癌。术中无需输血。术后住院时间为2至40天（平均=7天），41例（85.42%）患者在术后72小时内入住重症监护病房。总共9例（18.75%）患者出现术后并发症。总体死亡率为2.08%。
肝细胞癌和热带肝包虫病是主要的手术适应证疾病，大肝切除术是最常实施的手术。发病率和死亡率与全球主要中心的结果一致。
