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Article: Peri-operative care of patients with hepatocellular carcinoma undergoing hepatectomy

TitlePeri-operative care of patients with hepatocellular carcinoma undergoing hepatectomy
Authors
KeywordsCirrhosis
Hepatocellular carcinoma
Major hepatectomy
Peri-operative care
Issue Date1995
PublisherS Karger AG. The Journal's web site is located at http://www.karger.com/DSU
Citation
Digestive Surgery, 1995, v. 12 n. 1, p. 53-60 How to Cite?
AbstractPeri-operative care of patients with hepatocellular carcinoma is critical for the survival of cirrhotic patients undergoing major hepatectomy. Peri-operative nutritional support in the form of branched-chain amino-acid-enriched solution, medium chain triglyceride, inorganic phosphate and multivitamins may be beneficial in sustaining liver function after hepatectomy. Intra-operatively, anaesthetic agents which are potentially harmful to the liver should be avoided, and haemodynamic monitoring to ensure adequate volume replacement should be made to maintain hepatic blood flow. The surgeon has to prevent unnecessary liver injury and excessive bleeding, and to exercise the technique meticulously avoiding bile leakage, haematoma and excessive rotation of the liver which may result in twisting of inflow and outflow vascular pedicles. Postoperatively, prolonged monitoring of haemodynamics is essential; the use of mechanical ventilation enables adequate administration of intravenous analgesics without respiratory depression and provides appropriate oxygenation of the liver and prevents pleural effusion. In the immediate postoperative period, continuation of parenteral nutrition would be beneficial to maintain a higher level of short half-life carrier proteins, decrease the requirement of diuretics to control ascites, induce less weight loss and reduce septic morbidity. Early resumption of enteral feeding may positively affect hepatic function and regeneration, and should be instituted as soon as the bowel function returns.
Persistent Identifierhttp://hdl.handle.net/10722/43513
ISSN
2015 Impact Factor: 1.728
2015 SCImago Journal Rankings: 1.001

 

DC FieldValueLanguage
dc.contributor.authorFan, STen_HK
dc.contributor.authorTsui l, Sen_HK
dc.date.accessioned2007-03-23T04:47:38Z-
dc.date.available2007-03-23T04:47:38Z-
dc.date.issued1995en_HK
dc.identifier.citationDigestive Surgery, 1995, v. 12 n. 1, p. 53-60en_HK
dc.identifier.issn0253-4886en_HK
dc.identifier.urihttp://hdl.handle.net/10722/43513-
dc.description.abstractPeri-operative care of patients with hepatocellular carcinoma is critical for the survival of cirrhotic patients undergoing major hepatectomy. Peri-operative nutritional support in the form of branched-chain amino-acid-enriched solution, medium chain triglyceride, inorganic phosphate and multivitamins may be beneficial in sustaining liver function after hepatectomy. Intra-operatively, anaesthetic agents which are potentially harmful to the liver should be avoided, and haemodynamic monitoring to ensure adequate volume replacement should be made to maintain hepatic blood flow. The surgeon has to prevent unnecessary liver injury and excessive bleeding, and to exercise the technique meticulously avoiding bile leakage, haematoma and excessive rotation of the liver which may result in twisting of inflow and outflow vascular pedicles. Postoperatively, prolonged monitoring of haemodynamics is essential; the use of mechanical ventilation enables adequate administration of intravenous analgesics without respiratory depression and provides appropriate oxygenation of the liver and prevents pleural effusion. In the immediate postoperative period, continuation of parenteral nutrition would be beneficial to maintain a higher level of short half-life carrier proteins, decrease the requirement of diuretics to control ascites, induce less weight loss and reduce septic morbidity. Early resumption of enteral feeding may positively affect hepatic function and regeneration, and should be instituted as soon as the bowel function returns.en_HK
dc.format.extent1479301 bytes-
dc.format.extent27136 bytes-
dc.format.mimetypeapplication/pdf-
dc.format.mimetypeapplication/msword-
dc.languageengen_HK
dc.publisherS Karger AG. The Journal's web site is located at http://www.karger.com/DSUen_HK
dc.relation.ispartofDigestive Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCirrhosisen_HK
dc.subjectHepatocellular carcinomaen_HK
dc.subjectMajor hepatectomyen_HK
dc.subjectPeri-operative careen_HK
dc.titlePeri-operative care of patients with hepatocellular carcinoma undergoing hepatectomyen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0253-4886&volume=12&spage=53&epage=60&date=1995&atitle=Peri-operative+care+of+patients+with+hepatocellular+carcinoma+undergoing+hepatectomyen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.scopuseid_2-s2.0-0029089146en_HK
dc.identifier.hkuros8559-
dc.identifier.volume12en_HK
dc.identifier.issue1en_HK
dc.identifier.spage53en_HK
dc.identifier.epage60en_HK
dc.publisher.placeSwitzerlanden_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridTsui l, S=7004961348en_HK

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