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Article: Biliary complications after hepatic resection: Risk factors, management, and outcome

TitleBiliary complications after hepatic resection: Risk factors, management, and outcome
Authors
Issue Date1998
PublisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.com
Citation
Archives Of Surgery, 1998, v. 133 n. 2, p. 156-161 How to Cite?
AbstractObjective: To identify the risk factors for the development of biliary complications after hepatic resection and to evaluate management in relation to the outcomes of these patients. Design: Biliary complications are a common cause of major morbidity after hepatic resection. A survey was made of all patients undergoing hepatic resection at 1 institution. Perioperative risk factors related to the development of biliary complications were identified using multivariate analysis. Management and outcome were analyzed also. Setting: A tertiary referral center. Patients: From January 1, 1989, to October 31, 1995, 347 consecutive patients underwent 229 major and 118 minor hepatic resections. Main Outcome Measure: Development of postoperative biliary complications. Results: Biliary complications developed in 28 (8.1%) of 347 patients; these complications carried high risks for liver failure (35.7%) and operative mortality (39.3%). Stepwise logistic regression analysis identified increasing age, higher preoperative white blood cell count, left-sided hepatectomy, and prolonged operation time as the independent predictors of development of biliary complications. Conservative treatment or nonoperative measures alone, such as percutaneous drainage or endoscopic therapy, were effective in treating the complication in 13 of 19 patients, but those who required reoperation had a high mortality rate (7 [77.8%] of 9 patients). Patients with demonstrable leakage from the common bile duct or its bifurcation tended to have poor outcomes. Conclusions: Biliary complications are a common and serious cause of morbidity after hepatic resection. Preresection cholangiography for finding biliary tract anomaly is recommended before left-sided hepatectomy. Although nonoperative measures are the preferred approach for selected patients with biliary complications, those with demonstrable leakage from the common bile duct or its bifurcation have a grave prognosis and may benefit from early surgical intervention.
Persistent Identifierhttp://hdl.handle.net/10722/49320
ISSN
2014 Impact Factor: 4.926
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorLai, ECSen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2008-06-12T06:39:26Z-
dc.date.available2008-06-12T06:39:26Z-
dc.date.issued1998en_HK
dc.identifier.citationArchives Of Surgery, 1998, v. 133 n. 2, p. 156-161en_HK
dc.identifier.issn0004-0010en_HK
dc.identifier.urihttp://hdl.handle.net/10722/49320-
dc.description.abstractObjective: To identify the risk factors for the development of biliary complications after hepatic resection and to evaluate management in relation to the outcomes of these patients. Design: Biliary complications are a common cause of major morbidity after hepatic resection. A survey was made of all patients undergoing hepatic resection at 1 institution. Perioperative risk factors related to the development of biliary complications were identified using multivariate analysis. Management and outcome were analyzed also. Setting: A tertiary referral center. Patients: From January 1, 1989, to October 31, 1995, 347 consecutive patients underwent 229 major and 118 minor hepatic resections. Main Outcome Measure: Development of postoperative biliary complications. Results: Biliary complications developed in 28 (8.1%) of 347 patients; these complications carried high risks for liver failure (35.7%) and operative mortality (39.3%). Stepwise logistic regression analysis identified increasing age, higher preoperative white blood cell count, left-sided hepatectomy, and prolonged operation time as the independent predictors of development of biliary complications. Conservative treatment or nonoperative measures alone, such as percutaneous drainage or endoscopic therapy, were effective in treating the complication in 13 of 19 patients, but those who required reoperation had a high mortality rate (7 [77.8%] of 9 patients). Patients with demonstrable leakage from the common bile duct or its bifurcation tended to have poor outcomes. Conclusions: Biliary complications are a common and serious cause of morbidity after hepatic resection. Preresection cholangiography for finding biliary tract anomaly is recommended before left-sided hepatectomy. Although nonoperative measures are the preferred approach for selected patients with biliary complications, those with demonstrable leakage from the common bile duct or its bifurcation have a grave prognosis and may benefit from early surgical intervention.en_HK
dc.format.extent418 bytes-
dc.format.mimetypetext/html-
dc.languageengen_HK
dc.publisherAmerican Medical Association. The Journal's web site is located at http://www.archsurg.comen_HK
dc.relation.ispartofArchives of Surgeryen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subject.meshBiliary Tract Diseases - etiology - therapyen_HK
dc.subject.meshBiliary Tract Surgical Procedures - adverse effectsen_HK
dc.subject.meshLiver Diseases - surgeryen_HK
dc.subject.meshPostoperative Complications - etiology - therapyen_HK
dc.subject.meshLogistic Modelsen_HK
dc.titleBiliary complications after hepatic resection: Risk factors, management, and outcomeen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0004-0010&volume=133&issue=2&spage=156&epage=161&date=1998&atitle=Biliary+complications+after+hepatic+resection:+risk+factors,+management,+and+outcomeen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.doi10.1001/archsurg.133.2.156en_HK
dc.identifier.pmid9484727-
dc.identifier.scopuseid_2-s2.0-0031938981en_HK
dc.identifier.hkuros32004-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0031938981&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume133en_HK
dc.identifier.issue2en_HK
dc.identifier.spage156en_HK
dc.identifier.epage161en_HK
dc.identifier.isiWOS:000072063200007-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridLai, ECS=36932159600en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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