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26例肝癌行ALPPS围手术期并发症的观察分析
Clinical analysis of perioperative complications of 26 cases of liver cancer after ALPPS
- 第三军医大学学报 2019年41卷第15期 页码：1491-1496
- 作者机构：
- 作者简介：
- 基金信息：
DOI：10.16016/j.1000-5404.201902155
中图分类号：收稿：2019-02-28，
纸质出版：2019-08-15
- 稿件说明：
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曹永, 揭彬, 郑树国, 等. 26例肝癌行ALPPS围手术期并发症的观察分析[J]. 第三军医大学学报, 2019,41(15):1491-1496.
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.
曹永, 揭彬, 郑树国, 等. 26例肝癌行ALPPS围手术期并发症的观察分析[J]. 第三军医大学学报, 2019,41(15):1491-1496. DOI： 10.16016/j.1000-5404.201902155.
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
2
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
2
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
2
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
2
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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