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Function: _error_handler
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Filename: models/Detail_model.php
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Function: strpos
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Function: insertAPISummary
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Filename: helpers/my_audit_helper.php
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Filename: controllers/Detail.php
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Filename: controllers/Detail.php
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Background: A standardized definition of post-hepatectomy haemorrhage (PHH) has not yet been established.
Methods: An international study group of hepatobiliary surgeons from high-volume centres was convened and a definition of PHH was developed together with a grading of severity considering the impact on patients' clinical management.
Results: The definition of PHH varies strongly within the hepatic surgery literature. PHH is defined as a drop in haemoglobin level > 3 g/dl post-operatively compared with the post-operative baseline level and/or any post-operative transfusion of packed red blood cells (PRBC) for a falling haemoglobin and/or the need for radiological intervention (such as embolization) and/or re-laparotomy to stop bleeding. Evidence of intra-abdominal bleeding should be obtained by imaging or blood loss via the abdominal drains if present. Transfusion of up to two units of PRBC is considered as being Grade A PHH. Grade B PHH requires transfusion of more than two units of PRBC, whereas the need for invasive re-intervention such as embolization and/ or re-laparotomy defines Grade C PHH.
Conclusion: The proposed definition and grading of severity of PHH enables valid comparisons of results from different studies. It is easily applicable in clinical routine and should be applied in future trials to standardize reporting of complications.
Download full-text PDF |
Source |
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3163274 | PMC |
http://dx.doi.org/10.1111/j.1477-2574.2011.00319.x | DOI Listing |
Cureus
October 2024
Surgery, Kokura Memorial Hospital, Kitakyushu, JPN.
Introduction Anatomical hepatectomy for segment 7 (S7) lesions is technically challenging due to their restricted accessibility and close proximity to the right hepatic vein, and the robotic approach for this challenging situation is currently not supported by conclusive data. Methods We present our novel technique of robotic anatomical hepatectomy for S7 lesions utilizing the saline-linked cautery (SLiC) method. Between 2022 and 2023, 10 robotic S7 subsectionectomy or right posterior sectionectomy were performed and included in the current study.
View Article and Find Full Text PDFEur J Surg Oncol
October 2024
HPB, Minimally Invasive, Robotic and Transplant Surgery Unit, Department of Clinical Medicine and Surgery, Federico II University Hospital, Naples, Italy.
Background: Post-hepatectomy liver failure (PHLF) can significantly compromise outcomes, especially in cirrhotic patients. The identification of accurate and non-invasive pre-operative predictors is of paramount importance to appropriately stratify patients according to their estimated risk and select the best treatment strategy.
Materials And Methods: Consecutive patients undergoing liver resection for HCC on cirrhosis between 1-2015 and 12-2020 at 10 international Institutions were enrolled and their pre-operative CT scans were evaluated for the presence of spontaneous portosystemic shunts (SPSS) to identify predictors of PHLF and develop a nomogram.
Int J Mol Sci
October 2024
Department of Vascular Biology and Thrombosis Research, Centre of Physiology and Pharmacology, Medical University of Vienna, Schwarzspanierstrasse 17, A-1090 Vienna, Austria.
Cir Esp (Engl Ed)
December 2024
Senior Department of Hepatology, The Fifth Medical Center of Chinese People's Liberation Army General Hospital, Beijing, China. Electronic address:
Background And Aims: Total bile acid (TBA) is associated with portal hypertension, a risk factor for post-hepatectomy liver failure (PHLF). We conducted this study to clarify whether TBA is also associated with PHLF in patients with hepatocellular carcinoma (HCC).
Methods: We recruited patients with HCC and Child-Pugh class A, who underwent liver resection, and applied multivariate analyses to identify risk factors for PHLF.
Ann Surg
September 2024
Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
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