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Article: Hepatic resection for hepatolithiasis

TitleHepatic resection for hepatolithiasis
Authors
Issue Date1993
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 1993, v. 128 n. 9, p. 1070-1074 How to Cite?
AbstractObjective: To analyze the results of hepatic resection for hepatolithiasis. Design: A retrospective study of case records of patients with hepatolithiasis undergoing hepatic resection. These patients had been followed up for 3 to 38 months. They were referred to Queen Mary Hospital, a tertiary referral center in Hong Kong. Patients: Of 172 patients with hepatolithiasis seen between January 1984 and December 1981, 63 patients underwent hepatic resection because the affected liver segments were destroyed by repeated infection (n=51), multiple cholangitic liver abscesses were found in the affected liver segments (n=9), or concomitant intrahepatic cholangiocarcinoma was diagnosed (n=3). Intervention: Left lateral segmentectomy was performed in 42 patients, left hepatic lobectomy in 15 patients, right hepatic lobectomy in one patient, and segmentectomy in five patients. Main Outcome Measures: Postoperative morbidity and mortality analysis. Results: Contrary to hepatic resection in a normal liver, dissection to isolate inflow and outflow vasculature was difficult in 52% of cases owing to severe inflammatory fibrosis at the liver hilum, at the umbilical fissure, or at the junction of hepatic vein with inferior vena cava. The operative morbidity rate was 32% and the mortality rate was 2%. The majority of complications were wound infection, subphrenic abscesses, or biliary fistulas, which could be due to the presence of infected bile (85%) and liver abscesses (25%) in this disease. Statistical analysis of the preoperative hematological and biochemical variables and the amount of intraoperative blood loss could not identify any factor with significance in correlating with the development of postoperative complications. Stones recurred in 16% after a median follow-up of 47 months. Conclusion: Hepatic resection is a satisfactory treatment for hepatolithiasis. The postoperative septic complication rate is high and is an intrinsic problem related to liver resection in a septic condition.
Persistent Identifierhttp://hdl.handle.net/10722/172686
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2012-10-30T06:24:16Z-
dc.date.available2012-10-30T06:24:16Z-
dc.date.issued1993en_HK
dc.identifier.citationArchives Of Surgery, 1993, v. 128 n. 9, p. 1070-1074en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/172686-
dc.description.abstractObjective: To analyze the results of hepatic resection for hepatolithiasis. Design: A retrospective study of case records of patients with hepatolithiasis undergoing hepatic resection. These patients had been followed up for 3 to 38 months. They were referred to Queen Mary Hospital, a tertiary referral center in Hong Kong. Patients: Of 172 patients with hepatolithiasis seen between January 1984 and December 1981, 63 patients underwent hepatic resection because the affected liver segments were destroyed by repeated infection (n=51), multiple cholangitic liver abscesses were found in the affected liver segments (n=9), or concomitant intrahepatic cholangiocarcinoma was diagnosed (n=3). Intervention: Left lateral segmentectomy was performed in 42 patients, left hepatic lobectomy in 15 patients, right hepatic lobectomy in one patient, and segmentectomy in five patients. Main Outcome Measures: Postoperative morbidity and mortality analysis. Results: Contrary to hepatic resection in a normal liver, dissection to isolate inflow and outflow vasculature was difficult in 52% of cases owing to severe inflammatory fibrosis at the liver hilum, at the umbilical fissure, or at the junction of hepatic vein with inferior vena cava. The operative morbidity rate was 32% and the mortality rate was 2%. The majority of complications were wound infection, subphrenic abscesses, or biliary fistulas, which could be due to the presence of infected bile (85%) and liver abscesses (25%) in this disease. Statistical analysis of the preoperative hematological and biochemical variables and the amount of intraoperative blood loss could not identify any factor with significance in correlating with the development of postoperative complications. Stones recurred in 16% after a median follow-up of 47 months. Conclusion: Hepatic resection is a satisfactory treatment for hepatolithiasis. The postoperative septic complication rate is high and is an intrinsic problem related to liver resection in a septic condition.en_HK
dc.languageengen_US
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.subject.meshAdulten_US
dc.subject.meshAgeden_US
dc.subject.meshAged, 80 And Overen_US
dc.subject.meshBlood Loss, Surgicalen_US
dc.subject.meshCalculi - Mortality - Surgeryen_US
dc.subject.meshFemaleen_US
dc.subject.meshFollow-Up Studiesen_US
dc.subject.meshHepatectomy - Methodsen_US
dc.subject.meshHumansen_US
dc.subject.meshLiver Diseases - Mortality - Surgeryen_US
dc.subject.meshMaleen_US
dc.subject.meshMiddle Ageden_US
dc.subject.meshPostoperative Complicationsen_US
dc.subject.meshPreoperative Careen_US
dc.subject.meshRecurrenceen_US
dc.subject.meshRetrospective Studiesen_US
dc.titleHepatic resection for hepatolithiasisen_HK
dc.typeArticleen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.pmid8368927-
dc.identifier.scopuseid_2-s2.0-0027200563en_HK
dc.identifier.volume128en_HK
dc.identifier.issue9en_HK
dc.identifier.spage1070en_HK
dc.identifier.epage1074en_HK
dc.identifier.isiWOS:A1993LW00100022-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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