Original Scientific ArticlesPostoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume
Section snippets
Methods
Between January 1990 and February 1996, 284 patients with HCC underwent a hepatic resection at the Second Department of Surgery, Kyushu University. Postoperatively, 32 patients without viral markers such as hepatitis B surface antigen (HBs) and hepatitis C viral (HCV) antibody, or both, did not die of liver failure after hepatectomy. Of the 252 patients with viral markers such as HBs and HCV antibody, or both, 80 patients who underwent a major hepatectomy (no less than bisegmentectomies) were
Results
Seven of 80 patients (8.8%) who had major hepatectomies experienced postoperative liver failure. The patients who eventually died of liver failure lived for a range of 17 to 167 days after hepatectomy (mean survival after hepatectomy 85 ± 55 days). There was a patient who died within 30 days, while 2 (28.6%) lived more than 3 months.
In the major hepatectomy patients, no significant risk factors for liver failure were detected regarding age, gender, or preoperative liver function on
Discussion
The incidence of liver failure after hepatic resection has decreased because of recent advances in liver surgery, such as the introduction of intraoperative ultrasonography, the use of ultrasonic dissectors, and a more stringent patient selection.3, 14 The incidence of postoperative liver failure has yet to be qualified, so we reevaluated the risk factors for postoperative liver failure in the 1990s.
We defined postoperative liver failure as death within 1 year after hepatectomy. The mean
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