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肝切除术后并发症的危险因素及预测评分系统

陈龙 李钺

引用本文:
Citation:

肝切除术后并发症的危险因素及预测评分系统

DOI: 10.3969/j.issn.1001-5256.2019.01.048
详细信息
  • 中图分类号: R735.7

The risk factors and prediction systems for posthepatectomy complications

  • 摘要:

    肝切除术手术方式及过程较一般手术复杂,虽然其术后病死率较20世纪明显下降,但其术后并发症的发生率依旧居高不下。目前,关于肝切除术后并发症的危险因素及预测系统的研究依旧较少。介绍了肝切除术后并发症的定义,归纳分析了近年来各研究指出的胆漏、肝衰竭、术后出血以及Clavien-Dindo并发症的危险因素与预测系统,总结了术后并发症的共同危险因素:血小板减少、肝脏的非解剖性切除、大范围的肝脏组织切除以及低水平的血清白蛋白。通过提高外科人士对共同危险因素的认识与重视,降低术后并发症发生率,提高手术治疗满意度。

     

  • [1]MENDEZ-SANCHEZ N, RIDRUEJO E, ALVES DE MATTOS A, et al.Latin American Association for the Study of the Liver (LAASL) clinical practice guidelines:Management of hepatocellular carcinoma[J].Ann Hepatol, 2014, 13 (Suppl 1) :s4-s40.
    [2]BELGHITI J, HIRAMATSU K, BENOIST S, et al.Seven hundred forty-seven hepatectomies in the 1990s:An update to evaluate the actual risk of liver resection[J].J Am Coll Surg, 2000, 191 (1) :38-46.
    [3]SHUBERT CR, HABERMANN EB, TRUTY MJ, et al.Defining perioperative risk after hepatectomy based on diagnosis and extent of resection[J].J Gastrointest Surg, 2014, 18 (11) :1917-1728.
    [4]PENG JX, WANG LZ, DIAO JF, et al.Major hepatectomy for primary hepatolithiasis:A comparative study of laparoscopic versus open treatment[J].Surg Endosc, 2018, 32 (10) :4271-4276.
    [5]VARDAKOSTAS D, DAMASKOS C, GARMPIS N, et al.Minimally invasive management of hepatic cysts:Indications and complications[J].Eur Rev Med Pharmacol Sci, 2018, 22 (5) :1387-1396.
    [6]HASHIMOTO M, SASAKI K, MATSUDA M, et al.Hepatectomy for liver abscess caused by stones spilled during laparoscopic cholecystectomy[J].Asian J Endosc Surg, 2014, 7 (1) :60-62.
    [7]de WERRA E, ETTORRE GM, LEVI SANDRI GB, et al.Major hepatectomy for a symptomatic giant liver cavernous hemangioma[J].Hepatobiliary Surg Nutr, 2015, 4 (3) :218-219.
    [8]KINGHAM TP, CORREA-GALLEGO C, D'ANGELICA MI, et al.Hepatic parenchymal preservation surgery:Decreasing morbidity and mortality rates in 4, 152 resections for malignancy[J].J Am Coll Surg, 2015, 220 (4) :471-479.
    [9]BENZONI E, COJUTTI A, LORENZIN D, et al.Liver resective surgery:A multivariate analysis of postoperative outcome and complication[J].Langenbecks Arch Surg, 2007, 392 (1) :45-54.
    [10]RAHBARI NN, GARDEN OJ, PADBURY R, et al.Post-hepatectomy haemorrhage:A definition and grading by the International Study Group of Liver Surgery (ISGLS) [J].HPB (Oxford) , 2011, 13 (8) :528-535.
    [11]RAHBARI NN, GARDEN OJ, PADBURY R, et al.Posthepatectomy liver failure:A definition and grading by the International Study Group of Liver Surgery (ISGLS) [J].Surgery, 2011, 149 (5) :713-724.
    [12]KOCH M, GARDEN OJ, PADBURY R, et al.Bile leakage after hepatobiliary and pancreatic surgery:A definition and grading of severity by the International Study Group of Liver Surgery[J].Surgery, 2011, 149 (5) :680-688.
    [13]CLAVIEN PA, BARKUN J, de OLIVEIRA ML, et al.The Clavien-Dindo classification of surgical complications:Fiveyear experience[J].Ann Surg, 2009, 250 (2) :187-196.
    [14]YANG X, QIU Y, WANG W, et al.Risk factors and a simple model for predicting bile leakage after radical hepatectomy in patients with hepatic alveolar echinococcosis[J].Medicine (Baltimore) , 2017, 96 (46) :e8774.
    [15]NOJI T, TSUCHIKAWA T, EBIHARA Y, et al.Post-operative depletion of platelet count is associated with anastomotic insufficiency following intrahepatic cholangiojejunostomy:A casecontrol study from the results of 220 cases of intrahepatic cholangiojejunostomy[J].BMC surg, 2014, 14:81.
    [16]HARUKI K, SHIBA H, FUJIWARA Y, et al.Postoperative peripheral blood monocyte count correlates with postoperative bile leakage in patients with colorectal liver metastases after hepatic resection[J].Langenbecks Arch Surg, 2013, 398 (6) :851-855.
    [17]KAJIWARA T, MIDORIKAWA Y, YAMAZAKI S, et al.Clinical score to predict the risk of bile leakage after liver resection[J].BMC Surg, 2016, 16 (1) :30.
    [18]KILIC M, YOLDAS O, KOC M, et al.Can biliary-cyst communication be predicted before surgery for hepatic hydatid disease:does size matter?[J].Am J Surg, 2008, 196 (5) :732-735.
    [19]MARTIN AN, NARAYANAN S, TURRENTINE FE, et al.Clinical factors and postoperative impact of bile leak after liver resection[J].J Gastrointest Surg, 2018, 22 (4) :661-667.
    [20]GUILLAUD A, PERY C, CAMPILLO B, et al.Incidence and predictive factors of clinically relevant bile leakage in the modern era of liver resections[J].HPB (Oxford) , 2013, 15 (3) :224-229.
    [21]ANDREATOS N, AMINI N, GANI F, et al.Albumin-bilirubin score:Predicting short-term outcomes including bile leak and post-hepatectomy liver failure following hepatic resection[J].J Gastrointest Surg, 2017, 21 (2) :238-248.
    [22]PANARO F, HACINA L, BOUYABRINE H, et al.Risk factors for postoperative bile leakage:A retrospective single-center analysis of 411 hepatectomies[J].Hepatobiliary Pancreat Dis Int, 2016, 15 (1) :81-86.
    [23]STRUCKER B, STOCKMANN M, DENECKE T, et al.Intraoperative placement of external biliary drains for prevention and treatment of bile leaks after extended liver resection without bilioenteric anastomosis[J].World J Surg, 2013, 37 (11) :2629-2634.
    [24]LANGELLA S, RUSSOLILLO N, FORCHINO F, et al.Impact of obesity on postoperative outcome of hepatic resection for colorectal metastases[J].Surgery, 2015, 158 (6) :1521-1529.
    [25]SCHINDL MJ, REDHEAD DN, FEARON KC, et al.The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection[J].Gut, 2005, 54 (2) :289-296.
    [26]MICHALOPOULOS GK.Liver regeneration[J].J Cell Physiol, 2007, 213 (2) :286-300.
    [27]TOMIMARU Y, EGUCHI H, GOTOH K, et al.Platelet count is more useful for predicting posthepatectomy liver failure at surgery for hepatocellular carcinoma than indocyanine green clearance test[J].J Surg Oncol, 2016, 113 (5) :565-569.
    [28]GARCEA G, MADDERN GJ.Liver failure after major hepatic resection[J].J Hepatobiliary Pancreat Surg, 2009, 16 (2) :145-155.
    [29]IACONO C, RUZZENENTE A, CAMPAGNARO T, et al.Role of preoperative biliary drainage in jaundiced patients who are candidates for pancreatoduodenectomy or hepatic resection:Highlights and drawbacks[J].Ann Surg, 2013, 257 (2) :191-204.
    [30]TRUANT S, EL AMRANI M, SKRZYPCZYK C, et al.Factors associated with fatal liver failure after extended hepatectomy[J].HPB (Oxford) , 2017, 19 (8) :682-687.
    [31]KISHI Y, ABDALLA EK, CHUN YS, et al.Three hundred and one consecutive extended right hepatectomies:Evaluation of outcome based on systematic liver volumetry[J].Ann Surg, 2009, 250 (4) :540-548.
    [32]KHAN AS, GARCIA-AROZ S, ANSARI MA, et al.Assessment and optimization of liver volume before major hepatic resection:Current guidelines and a narrative review[J].Int JSurg, 2018, 52:74-81.
    [33]ASENBAUM U, KACZIREK K, BA-SSALAMAH A, et al.Posthepatectomy liver failure after major hepatic surgery:Not only size matters[J].Eur Radiol, 2018.[Epub ahead of print]
    [34]POORDAD FF.Presentation and complications associated with cirrhosis of the liver[J].Curr Med Res Opin, 2015, 31 (5) :925-937.
    [35]LIN YX, HE XB.Clinical features of drug-induced liver injury and related risk factors[J].J Clin Hepatol, 2018, 34 (6) :1237-1241. (in Chinese) 林云霞, 何晓彬.药物性肝损伤的临床特点及危险因素分析[J].临床肝胆病杂志, 2018, 34 (6) :1237-1241.
    [36]TANG DS, LI FJ.Current status of research on liver failure after liver cancer resection[J].J Clin Hepatol, 2018, 34 (5) :1123-1127. (in Chinese) 唐德胜, 李福军.肝癌切除术后肝衰竭的研究现状[J].临床肝胆病杂志, 2018, 34 (5) :1123-1127.
    [37]SATO N, KENJO A, KIMURA T, et al.Prediction of major complications after hepatectomy using liver stiffness values determined by magnetic resonance elastography[J].Br JSurg, 2018.[Epub ahead of print]
    [38]BREITENSTEIN S, DEOLIVEIRA ML, RAPTIS DA, et al.Novel and simple preoperative score predicting complications after liver resection in noncirrhotic patients[J].Ann Surg, 2010, 252 (5) :726-734.
    [39]OTTO G, HOPPE-LOTICHIUS M, BLETTNER M.Novel and simple preoperative score predicting complications after liver resection in noncirrhotic patients[J].Ann Surg, 2011, 254 (5) :831.
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  • 出版日期:  2019-01-20
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