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. 1986 Feb;203(2):148–152. doi: 10.1097/00000658-198602000-00007

Intraperitoneal septic complications after hepatectomy.

K Yanaga, T Kanematsu, K Takenaka, K Sugimachi
PMCID: PMC1251062  PMID: 3947153

Abstract

One hundred forty-nine elective hepatic resections were performed during the 12 years from 1973 to 1984. Nineteen of these patients (12.8%) developed intraperitoneal septic complications after hepatectomy (IPSCH), of whom 13 died of liver failure. Perioperative variables associated with IPSCH were as follows: (1) right or extended right lobectomy, (2) age greater than 65, (3) operation time greater than 5 h, (4) blood loss at operation greater than 3000 g, and (5) post-operative bleeding, which required laparotomy for hemostasis. Improved outcome of IPSCH since 1981 coincided with the emergence of opportunistic pathogens. Survivors of IPSCH had been diagnosed earlier, all by culture of the subphrenic drainage, and all had a lower bilirubin level at the time of diagnosis. It is concluded that secure hemostasis and avoidance of tissue devitalization during hepatectomy are essential to reduce the incidence of IPSCH and that routine culture of the subphrenic drainage will improve the outcome of IPSCH.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Burchard K. W., Minor L. B., Slotman G. J., Gann D. S. Staphylococcus epidermidis sepsis in surgical patients. Arch Surg. 1984 Jan;119(1):96–100. doi: 10.1001/archsurg.1984.01390130078014. [DOI] [PubMed] [Google Scholar]
  2. Dougherty S. H. Role of enterococcus in intraabdominal sepsis. Am J Surg. 1984 Sep;148(3):308–312. doi: 10.1016/0002-9610(84)90460-4. [DOI] [PubMed] [Google Scholar]
  3. Fortner J. G., Kim D. K., Maclean B. J., Barrett M. K., Iwatsuki S., Turnbull A. D., Howland W. S., Beattie E. J., Jr Major hepatic resection for neoplasia: personal experience in 108 patients. Ann Surg. 1978 Sep;188(3):363–371. doi: 10.1097/00000658-197809000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fortner J. G., MacLean B. J., Kim D. K., Howland W. S., Turnbull A. D., Goldiner P., Carlon G., Beattie E. J., Jr The seventies evolution in liver surgery for cancer. Cancer. 1981 May 1;47(9):2162–2166. doi: 10.1002/1097-0142(19810501)47:9<2162::aid-cncr2820470909>3.0.co;2-5. [DOI] [PubMed] [Google Scholar]
  5. Fry D. E., Garrison R. N., Heitsch R. C., Calhoun K., Polk H. C., Jr Determinants of death in patients with intraabdominal abscess. Surgery. 1980 Oct;88(4):517–523. [PubMed] [Google Scholar]
  6. Garrison R. N., Cryer H. M., Howard D. A., Polk H. C., Jr Clarification of risk factors for abdominal operations in patients with hepatic cirrhosis. Ann Surg. 1984 Jun;199(6):648–655. doi: 10.1097/00000658-198406000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Hau T., Simmons R. L. 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 May;87(5):588–592. [PubMed] [Google Scholar]
  8. Hodgson W. J., DelGuercio L. R. Preliminary experience in liver surgery using the ultrasonic scalpel. Surgery. 1984 Feb;95(2):230–234. [PubMed] [Google Scholar]
  9. Iwatsuki S., Shaw B. W., Jr, Starzl T. E. Experience with 150 liver resections. Ann Surg. 1983 Mar;197(3):247–253. doi: 10.1097/00000658-198303000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]
  10. Jaundice due to bacterial infection. Gastroenterology. 1979 Aug;77(2):362–374. [PubMed] [Google Scholar]
  11. Kanematsu T., Takenaka K., Matsumata T., Furuta T., Sugimachi K., Inokuchi K. Limited hepatic resection effective for selected cirrhotic patients with primary liver cancer. Ann Surg. 1984 Jan;199(1):51–56. doi: 10.1097/00000658-198401000-00009. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Lee N. W., Wong J., Ong G. B. The surgical management of primary carcinoma of the liver. World J Surg. 1982 Jan;6(1):66–75. doi: 10.1007/BF01656375. [DOI] [PubMed] [Google Scholar]
  13. Norton L., Moore G., Eiseman B. Liver failure in the postoperative patient: the role of sepsis and immunologic deficiency. Surgery. 1975 Jul;78(1):6–13. [PubMed] [Google Scholar]
  14. Ottow R. T., Barbieri S. A., Sugarbaker P. H., Wesley R. A. Liver transection: a controlled study of four different techniques in pigs. Surgery. 1985 May;97(5):596–601. [PubMed] [Google Scholar]
  15. Thompson H. H., Tompkins R. K., Longmire W. P., Jr Major hepatic resection. A 25-year experience. Ann Surg. 1983 Apr;197(4):375–388. doi: 10.1097/00000658-198304000-00001. [DOI] [PMC free article] [PubMed] [Google Scholar]

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