A STUDY ON POSTOPERATIVE COMPLICATIONS AFTER HEPATECTOMY WITH SPECIAL REFERENCE TO THE OPERATIVE METHODS

Abstract

We investigated postoperative complications including pneumonitis, pleural effusion, intraabdominal abscess, and bile leakage in 134 patients treated with hepatectomy with special references to the method of hepatic transection, the extent and the site of resection. Patients were categorized into three groups according to the methods used for hepatic transection: microwave tissue coagulator (MTC) group (n=25); cavitron ultrasonic surgical aspiration system (CUSA) group (n=52); and the other group (n=57). Comparisons were also made among patients having limited hepatic resection (_??_HrS:n=70), intermediate resection (Hr1:n=20), and extensive resection (Hr2_??_;n=44). Furthermore, the limited resections of S7 and S8 were distinguished from those of other sites. Each postoperative complication in the MTC group tended to be higher than those in the other two groups. The rate of pneumonitis reached to as high as 32% in the MTC group, which was significantly higher than that (5.8%) of the CUSA group (p<0.01). In the MTC group, the bile leakage occurred more frequently in patients treated with extensive resection (83.3%) as compared to that with limited resection (5.3%, p<0.01). In patients with limited resections, postoperative complications such as pleural effusion, pneumonitis, and intraabdominal abscess occurred more frequently in S7 or S8 resection. Therefore, it is concluded that adequate drainage is of particular importance in controlling infection and bile leakage of the transacted margin after hepatectomy using MTC and that of S7 or S8.