Review
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World J Gastroenterol. Nov 28, 2013; 19(44): 7983-7991
Published online Nov 28, 2013. doi: 10.3748/wjg.v19.i44.7983
Management of post-hepatectomy complications
Shan Jin, Quan Fu, Gerile Wuyun, Tu Wuyun
Shan Jin, Gerile Wuyun, Tu Wuyun, Department of General Surgery, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
Quan Fu, Department of Clinical Laboratory, Affiliated Hospital of Inner Mongolia Medical University, Hohhot 010050, Inner Mongolia Autonomous Region, China
Author contributions: Jin S, Fu Q, Wuyun G and Wuyun T designed the research and analyzed the data; Jin S performed the research and wrote the paper.
Supported by Inner Mongolia Science Foundation, No. 2009BS1103; and Inner Mongolia Public Health Department Clinical and Health Research Projects, No. 2010042
Correspondence to: Shan Jin, MD, PhD, Department of General Surgery, Affiliated Hospital of Inner Mongolia Medical University, Tongdao South Rd, Hohhot 010050, Inner Mongolia Autonomous Region, China. jinshangood@163.com
Telephone: +86-471-6637645 Fax: +86-471-6637645
Received: August 13, 2013
Revised: September 29, 2013
Accepted: October 17, 2013
Published online: November 28, 2013
Processing time: 119 Days and 16.4 Hours
Abstract

Hepatic resection had an impressive growth over time. It has been widely performed for the treatment of various liver diseases, such as malignant tumors, benign tumors, calculi in the intrahepatic ducts, hydatid disease, and abscesses. Management of hepatic resection is challenging. Despite technical advances and high experience of liver resection of specialized centers, it is still burdened by relatively high rates of postoperative morbidity and mortality. Especially, complex resections are being increasingly performed in high risk and older patient population. Operation on the liver is especially challenging because of its unique anatomic architecture and because of its vital functions. Common post-hepatectomy complications include venous catheter-related infection, pleural effusion, incisional infection, pulmonary atelectasis or infection, ascites, subphrenic infection, urinary tract infection, intraperitoneal hemorrhage, gastrointestinal tract bleeding, biliary tract hemorrhage, coagulation disorders, bile leakage, and liver failure. These problems are closely related to surgical manipulations, anesthesia, preoperative evaluation and preparation, and postoperative observation and management. The safety profile of hepatectomy probably can be improved if the surgeons and medical staff involved have comprehensive knowledge of the expected complications and expertise in their management. This review article focuses on the major postoperative issues after hepatic resection and presents the current management.

Keywords: Hepatectomy; Postoperative complication; Management

Core tip: Despite technical advances and high experience of liver resection of specialized centers, it is still burdened by relatively high rates of postoperative morbidity and mortality. Common post-hepatectomy complications include fever, hemorrhage, bile leakage, liver failure, pleural effusion, and subphrenic infection. The aim of this study was to summary the causes for post-hepatectomy complications and to discuss the prevention and treatment trick for postoperative complications.