肝段切除术及并发症的评估

EVALUATION OF SEGMENTAL LIVER RESECTION AND THE COMPLICATIONS

作者复习了72例肝段切除术病人。全组无1例死亡,并发症率30.6％,手术时间168±62分钟,失血量622±483ml,输血量739±419ml,入肝血流阻断时间28±13分钟,住院时间23±12天。根据术前,术中变量通过多变量回归分析方法识别并发症的影响因素,结果显示:并发症将显著延长住院时间(P=0.0032),而术前血清白蛋白水平(P=0.0568)和术中输血量(P=0.00578),与并发症有边缘性显著关系。非肝硬化组与肝硬化组术后并发症无显著差别(P=0.552)。结果提示肝段切除术是一种非常可取的技术,提高血清白蛋白值,减少术中输血可能降低并发症率。

Seventy-two patients who underwent segmental liver resection were reviewed. None of them died after operation. The postoperative complication rate was 30.6% . The mean operative time was 168 ± 62 minutes, the mean operative blood loss was 622 ± 483ml, the mean blood transfusion was 739 ± 418ml.The mean duration of hepatic inflow occlusion was 28 ± 13 minutes, and mean duration of the hospital stay was 23 ± 12 days .Various preoperative and intraoperative factors were analysed by using multiple regression in logistic model to identify the influence of the factors in morbidity. The result showed that complication could significantly prolong the length of hospital stay(P = 0.0032) .Statistically marginally significant correlation existed between the complications and the level of preoperative serum albumin (P = 0.0568), or the amount of intraoperative blood transfused (P = 0.0578) .There was no significant difference in morbidity between cirrhotic and noncirrhotic group (P = 0.552) The results indicate that segmental liver resection is a safe operation with a low incidence of postopecative complications.