Delayed return of gastrointestinal function after partial hepatectomy: a single-center cross-sectional study.

Abstract

Introduction Partial hepatectomy (PH) remains associated with complication rates around 30-50%. Delayed return of gastrointestinal function (DRGF) has been reported in 10-20%. This study aimed to assess DRGF predictors after PH. Aim This retrospective study aimed to assess DRGF predictors after PH. Methods All patients who underwent PH between 01/2010 and 12/2019 were included. DRGF was defined as need of postoperative nasogastric tube (NGT). Independent DRGF predictors were identified with multivariable logistic binary regression. Results Overall, 501 patients were included. DRGF occurred in 82 patients (16%). A hundred-and-twelve patients (22%) underwent a minimally invasive approach and DRGF incidence was significantly lower in this group (p <0.001). DRGF was more frequent after major PH (p<0.001). DRGF occurred more often in patients with preoperative embolization (p<0.001), biliary anastomosis (p<0.001) and extrahepatic resection (p<0.001). Patients with DRGF had longer median operation duration (p<0.001), more biliary leaks/bilomas (p<0.001) and higher median blood loss (p<0.001). DRGF patients developed more pneumonias (p<0.001) and had longer median length of stay (p<0.001). On multivariable analysis, operation duration (p<0.001), major hepatectomy (p<0.001) and postoperative biloma/biliary leak (p<0.001) were independently associated with DRGF occurrence. Conclusion Postoperative DRGF occurred in 16% of the patients and was associated with longer length of stay. Surgery duration, major PH and postoperative biloma/biliary leak were found as independent predictors of DRGF.