Prolonged portal triad clamping increases postoperative sepsis after major hepatectomy in patients with sinusoidal obstruction syndrome and/or steatohepatitis.

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Date publication

août 2012

Auteurs

Membres identifiés du Cancéropôle Est :
Pr BACHELLIER Philippe, Pr CHENARD Marie-Pierre


Tous les auteurs :
Narita M, Oussoultzoglou E, Fuchshuber P, Chenard MP, Rosso E, Yamamoto K, Jaeck D, Bachellier P

Résumé

BACKGROUND: Portal triad clamping (PTC) has been widely adopted in an attempt to decrease bleeding during liver parenchymal transection. As a larger proportion of patients are treated with chemotherapy prior to liver resection, the safety of PTC in patients with chemotherapy-associated liver injury remains poorly investigated. This study aims to evaluate the influence of PTC on early postoperative outcomes in patients with chemotherapy-associated liver injury undergoing major hepatectomy for colorectal liver metastases (CLM). PATIENTS AND METHODS: From January 2000 to October 2010, 53 patients with histologically proven chemotherapy-associated liver injuries [sinusoidal obstruction syndrome (SOS; n = 41), steatohepatitis (n = 5), and both SOS and steatohepatitis (n = 7)] who underwent major hepatectomy for CLM were divided into two groups; patients undergoing intermittent TPC (n = 20) and those who did not undergo TPC (n = 33). Perioperative clinicobiological factors, morbidity including septic complications, and mortality were analyzed and compared between the two groups. RESULTS: Intraoperative blood transfusions and postoperative liver function were comparable between the two groups. Sepsis and biloma occurred more often in patients undergoing PTC longer than 30 min than in those undergoing PTC 30 min) and the ratio of future liver remnant volume to total liver volume

Référence

World J Surg. 2012 Aug;36(8):1848-57