Risk factors of postoperative morbidity after hepatectomy for intrahepatic stones

Abstract

Objective To study the risk factors of complications after hepatectomy for intrahepatic stone.Method Clinical data of 363 patients with hepatolithiasis receiving elected hepatic resection in past 4 years in our hospital were analyzed retrospectively.Postoperative complications were recorded.Possible risk factors pertaining to the development of complications were identified using univariate and multivariate analysis.Results the surgical mortality was 0.6%(2/363).Postoperative complications occurred in 110 of 363 patients(30.3%).The morbidity included wound infection/liquafication in 42 cases(11.6%),pleural effusion in 41(11.3%),subphrenic collection in 36 (9.9%),bile leakage in 21(5.8%),intra-abdominal collection/infection in 13(3.6%),gastrointestinal bleeding in 3(0.8%),biliary hemorrhage in 2(0.6%),hepatic function insufficiency in 1 (0.3%).The multivariate logistic regression analysis identified that previous history of biliary surgery (P=0.042,odds ratio[OR]=0.617,95%confidence interval[CI]:0.388 to 0.982)and operative time(P=0.0001,odds ratio[OR]=0.994,95%confidence interval[CI]:0.991 to 0.997)were the independent risk factors for development of complications after hepatoectomy for hepatolithiasis.Conclusion Previous history of biliary duct surgery and operative time are the independent risk factors for development of complications after hepatoectomy for intrahepatic stone.For patients with previous biliary surgery,adequate preoperative preparation,improving operative skills and shortening operative time are critical important to prevent occurrence of complications. Key words: Hepatoectomy; Hepatolithiasis; Complication