Analysis of 210 elective hepatic resections

BACKGROUND/AIMS: Based on our personal cases, the mortality and morbidity of hepatectomy were analyzed. METHODOLOGY: Between April 1988 and October 1995, 210 elective hepatectomies were perf. RESULTS: There were no intraoperative deaths, 5 perioperative deaths and 4 in-hospital deaths. Major complications occurred in 47 patients (22.4%). Minor complications included 44 mild pleural effusions not requiring treatment, 29 wound dehiscences, and 1 case of hoarseness. Multiple regression analysis showed that wound dehiscence and pleural effusions were associated with prothrombin time (t = -2.41, p = 0.017) and incision type (t = 5.57, p < 0.001), respectively. Ascites were associated with operative time (t = 2.25, p = 0.026), blood transfusion (t = 2.23, p = 0.027), prothrombin time (t = 2.16, p = 0.032), and serum total bilirubin (t = -2.026, p = 0.044). Postoperative bleeding was associated with blood loss (t = 3.92, p = 0.0001), blood transfusion (t = -2.73, p = 0.007), and additional surgery (t = 2.15, p = 0.033). CONCLUSION: The mortality of elective hepatic resection can be decreased by adherence to strict surgical indications and meticulous surgical technique. The use of autologous blood transfusion may reduce perioperative complications and morbidity.