Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS

Yong CAO; Bin JIE; Shuguo ZHENG; Li CAO; Li MA; Yujun JI

doi:10.16016/j.1000-5404.201902155

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Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS

更新时间：2026-01-09

- Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS
- Journal of Third Military Medical University Vol. 41, Issue 15, Pages: 1491-1496(2019)
- 作者机构：
- 作者简介：
- 基金信息：
- DOI：10.16016/j.1000-5404.201902155
  CLC：
- Received：28 February 2019，
  
  Published：15 August 2019
- 稿件说明：
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Yong CAO, Bin JIE, Shuguo ZHENG, et al. Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS[J]. Journal of Third Military Medical University, 2019, 41(15): 1491-1496.
DOI：

Yong CAO, Bin JIE, Shuguo ZHENG, et al. Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS[J]. Journal of Third Military Medical University, 2019, 41(15): 1491-1496. DOI： 10.16016/j.1000-5404.201902155.

摘要

Abstract

Objective

To analyze the characteristics of perioperative liver function and complications in hepatocellular carcinoma (HCC) patients undergoing associating liver partition and portal vein ligation for staged hepatectomy (ALPPS

two-stage

hepatectomy and portal vein ligation).

Methods

Twenty-six patients undergoing ALPPS due to advanced HCC in our hospital from July 2014 to June 2017 were enrolled in this study. The indexes of liver function and their trends were observed in the perioperative period. The occurrence

development

treatment and outcomes of complications were also observed.

Results

The trend of liver function showed that after the first and second operations

alanine aminotransferase (ALT) level reached a peak on the first 1~2 d after surgery

and then decreased rapidly; total bilirubin (TB) reached the highest level on the 3rd~4th days after the first operation

maintained at a high level on the first 1 to 5 d after the second stage of surgery

and then gradually decreased to normal. One patient developed a "bilirubin-transaminase discrepancy" phenomenon in which the transaminase levels were gradually decreased while TB level was progressively elevated in 6 d after the secondary operation

and then developed into liver failure. In terms of complications

the highest incidence was pleural effusion

including 9 cases (34.6%

with 8 on the 3rd to 7th days after operation

and thoracic drainage in 1 case) in the first stage

and 12 cases (46.2%

with 10 cases on the 8th to 12th days postoperatively

and thoracic puncture drainage or drainage in 11 case) after the second operation. The incidence of infectious complications was 15.4% in the first phase and 26.9% after the second operation

and the lung infection was most common.

Conclusion

After ALPPS

transaminase and bilirubin show a trend of first rise and then falling within 1 week after operation. Pleural effusion is the most common complication after operation

and easy to occur in the first week after the first operation and second week after the second stage of surgery. Therefore

active prevention of lung infection is helpful to reducing the incidence of perioperative infection complications.

关键词

Keywords

references

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