Risk factors analysis of reoperation after irregular hepatectomy for patients with liver neoplasms and liver cirrhosis

Abstract

Objective To analyze the risk factors of reoperation after irregular hepatectomy for patients with liver neoplasms and liver cirrhosis. Methods Clinical data of 169 patients with liver neoplasms and liver cirrhosis who underwent irregular hepatectomy in Sun Yat-sen Memorial Hospital of Sun Yat-sen University between January 2011 and January 2015 were retrospectively analyzed. Among the patients, 106 were males and 63 were females, aged 25-79 years old with a median age of 56 years old. The informed consents of all patients were obtained and the local ethical committee approval was received. According to the patients received reoperation after irregular hepatectomy or not, all patients were divided into the reoperation group (n=18) and non-reoperation group (n=151). The reoperation rate and causes were observed, and the risk factors of reoperation were analyzed. The relationship between the reoperation and clinical parameters was analyzed by Chi-square test or Fisher's exact probability method. The risk factors of reoperation were analyzed by Logistic regression analysis. Results The reoperation rate was 10.7% (18/169). The main causes of reoperation included abdominal bleeding (n=10), abdominal infection (n=3), bile leakage (n=3) and incision rupture (n=5). No death was observed. Preoperative ALB level<35 g/L, preoperative diabetes mellitus and intraoperative blood loss≥500 ml were the independent risk factors of reoperation after irregular hepatectomy for patients with liver neoplasms and liver cirrhosis (OR=3.775, 0.055, 0.280; P<0.05). Conclusions Abdominal bleeding, abdominal infection, bile leakage and insicion rupture are the main casues of reoperation after irregular hepatectomy for the patients with liver neoplasms and liver cirrhosis. Preoperative ALB level<35 g/L, preoperative diabetes mellitus and intraoperative blood loss≥500 ml are the independent risk factors for them. Key words: Liver neoplasms; Liver cirrhosis; Hepatectomy; Reoperation; Risk factors