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Outcomes of extended hepatectomy for hepatobiliary tumors. Initial experience from a non-university hepatobiliary center.

肝胆肿瘤扩大肝切除术的结局。来自非大学肝胆中心的初步经验。

  • 影响因子:2.11
  • DOI:10.1016/j.amjsurg.2019.05.007
  • 作者列表:"Attili A","Sucandy I","Spence J","Bourdeau T","Ross S","Rosemurgy A
  • 发表时间:2020-01-01
Abstract

INTRODUCTION:Hepatectomy is the gold standard curative treatment for hepatic neoplasms in patients with preserved liver function. Many large tumors require extended hepatectomy (EH). Possibility of developing major postoperative complications including liver failure is feared by many surgeons. We aim to describe our outcomes of EH for large hepatobiliary tumors. MATERIAL AND METHODS:All patients undergoing hepatectomy between 2012 and 2017 were prospectively followed. RESULTS:91 patients underwent hepatectomy with ten patients underwent EH. The majority of patients were women, age of 63, BMI of 24, and MELD score of 11. Six patients underwent an extended right hepatectomy, while four patients underwent extended left hepatectomy. Operative time was 224 min with estimated blood loss of 500 ml. No intraoperative complications were seen. Two patients experienced postoperative complications (pleural effusion in one patient and respiratory failure in another). Length of ICU stay was 2 days, and hospital stay was 5 days. 80% of the patients are currently alive with median follow-up of 41.2 months. CONCLUSION:EH can be undertaken safely with acceptable morbidity and mortality in our center.

摘要

引言: 肝切除术是肝功能保留的肝肿瘤患者的金标准治愈性治疗。许多大肿瘤需要扩大肝切除术 (EH)。许多外科医生担心发生包括肝功能衰竭在内的主要术后并发症的可能性。我们旨在描述我们对大型肝胆肿瘤 EH 的结局。 材料和方法: 对 2017 和 2012年行肝切除术的所有患者进行前瞻性随访。 结果: 91 例患者行肝切除术,10 例患者行 EH。患者以女性居多,年纪为 63 岁,BMI 为 24,MELD 评分为 11。6 例患者行扩大右肝切除术,4 例患者行扩大左肝切除术。手术时间 224 min,估计失血量 500 ml。未见术中并发症。2 例患者出现术后并发症 (1 例患者出现胸腔积液,另 1 例出现呼吸衰竭)。ICU 住院时间为 2 天,住院时间为 5 天。80% 的患者目前存活,中位随访时间为 41.2 个月。 结论: 本中心可以安全地进行 EH,发病率和死亡率均可接受。

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