MORBIDITY AND MORTALITY AFTER HEPATIC RESECTION IN THE MODERN-ERA

Background/Aims: The purpose of this study was to clarify the risk fac tors associated with complications following hepatic resections and di scuss the appropriate types of perioperative management. Materials and Methods: A retrospective analysis was made of the complications in 35 5 patients undergoing hepatic resection between April 1985 and August 1992 at the Second Department of Surgery, Kyushu University Hospital. The patients were placed in. true groups according to the occurrence o f compications: patients with morbidity and/or mortality (187 patients ); patients without either morbidity or mortality (168 patients). Resu lts: The leading complications were the accumulation of fluid in the a bdominal and pleural cavities along with septic complications. The onl y significant factor affecting morbidity and mortality among the preop erative medical conditions was the presence of diabetes while, in addi tion, the patients with morbidity and/or mortality had higher levels o f perioperative transaminase and serum creatinine as compared with tho se in patients without either morbidity or mortality. Conclusions: The perioperative strategies for reducing morbidity include the strict co ntrol of diabetes to reduce septic complications as well as preserve r enal function, which can protect against the refractory accumulation, of fluid in, the peritoneal and pleural cavities.