Surgical complications of liver resections

Abstract

Background: Liver resection has been increasingly performed over the last 2 decades worldwide because of improved postoperative outcomes and evidence that this approach offers the only chance of cure in many patients. Technical innovations have mainly focused on minimizing bleeding during transection of the hepatic parenchyma because excessive hemorrhage and the need for blood transfusion are associated with increased postoperative morbidity and mortality Liver resection is still a high risk procedure because of difficulties in preoperative assessment of functional liver volume and severity of co-morbidity, complexities of surgical procedures for preserving enough functional liver and preventing injury to mcyor vessels in the remnant liver. Although zero mortality can be achieved during a limited period in some centers, the postoperative mortality in most studies is between 1%-5%, even in patients with normal liver background. Postoperative death can be attributed to liver failure, infection in surgical site, bleeding from esophageal varices, bile leakage, and extrahepatic diseases. Methods: In this study, we classified postoperative complications into major and minor ones according to their fatal potential. We hypothesized that improved surgical technique can decrease surgical complications, while patient selection and careful perioperative management are important to prevent mcyor complications. Randomized collection of twenty nine patients underwent partial hepatectomy for different indications. Analysis of every case has been done, retrospectively Results: In this study, the most common indication of liver resection was liver tumors accounting for 82.7% of cases, primary hepatic malignancy accounting for 75.8%. Extension of liver resection was a predictor factor of complication. Major complications were observed with rate of 29. 4% in patients who were subjected to major resections. The most common complication was liver decompensation accounting for 24.1%, was observed in cirrhotic patients. Conclusion: Our findings demonstrate that liver resection can be performed with low mortality and acceptable morbidity rates. Surgical complications can be reduced by employing meticulous surgical technique and, whenever indicated, vascular exclusion. In addition, use of vaccine against HBV eventually decreases the incidence, especially in endemic areas, and prevents the development of cirrhosis, which predisposes to hepatocellular carcinoma and liver decompensation after rersection.