The retrospective study on high risk factors of subphrenic infection after hepatectomy

Abstract

In order to identify the high risk factors that determine subphrenic infection after hepatectomy, 187 liver resections performed during January, 1985 to December, 1990 in Department of Surgery of Tongji Hospital were reviewed. Thirteen patients developed subphrenic infection with the incidence of subphrenic infection being 6. 95 %. The results of retrospective study on 187 liver resections demonstrated that the high risk factors related to subphrenic infection after hepatectomy were as follows: (1) The extent of liver resection was associated with subphrenic infection. (2) The incidence of subphrenic infection after liver resection of primary liver cancer patients with hepatic cirrhosis was higher than that of non-cirrhotic patients. (3) Intraoperative estimated blood loss greater than 1500 ml was found to be a significant risk factor in the development of postoperative subphrenic infection. (4) Adequate postoperative drainage of subdiaphragm and the raw surface of the liver was one of critical factors of decreasing subphrenic infection after liver resection.

Keywords

hepatectomy / complication / subphrenic infection / etiology

References

[1] PaceR F, BlenkharnJ I, EdwardsW J, et al.. Intra-abdominal sepais after hepatic resection. Ann Surg, 1989, 209(3): 302-302

[2] YanagaK, KanematsuT, TakenakaK, et al.. Intraaperitoneal septic complications after hepatectomy. Ann Surg, 1986, 203(2): 148-148

[3] IwatsukiS, StarzlT E. Personal experience with 411 hepatic resection. Ann Surg, 1988, 208(4): 421-421

[4] YurtR W, ShiresG T. Increased susceptibility to infection due to infusion of exogenous chemotaxin. Arch Surg, 1987, 122(1): 111-111

[5] LeeJ T, AhrenholzD H, NelsonR D, et al.. Mechanisms of the adjuvant effect of hemoglobin in experimental peritonitis V. The significance of the coordinated iron component. Surgery, 1979, 86(1): 41-41

[6] HauT, LeeJ T, SimmonR L, et al.. Mechanisms of the adjuvant effect of hemoglobin in experimental peritonitis III. The influence of hemoglobin on phagocytosis and intracellular killing by human granulocytes. Surgery, 1980, 87(5): 588-588

[7] QuQ J. The role of hepatic vein in liver operations. Surgery, 1984, 95(4): 381-381

[8] SchwartS I. Hepatic resection. Ann Surg, 1990, 211(1): 1-1

[9] ScottC M. Intraabdominal sepsis after hepatic trauma. Am J Surg, 1988, 155(2): 284-284

[10] WuM C, ZhangX H, ChenH, et al.. Experiences in 467 cases of hepatic resection. Acta Acade Med Wuhan, 1983, 3(1): 1-1