Department of Surgery, North Shore Hospital, Private Bag Auckland, New Zealand. Electronic address:
Published: January 2022
AI Article Synopsis
Article Abstract
Purpose: Acetaminophen is commonly used for post-operative analgesia following liver resection. It is metabolised by the liver and appropriate administration and dosage is in question in in patients undergoing hepatectomy. A systematic review was conducted to investigate safety and efficacy of acetaminophen use.
Methods: MEDLINE, EMBASE, PubMed, Web of Science, and Google Scholar were searched for instances of toxicity, liver dysfunction, and analgesic efficacy in patients undergoing hepatectomy.
Results: Two randomised controlled trials and four prospective observational studies were included. The studies were of moderate quality. Four studies investigated post-operative levels of acetaminophen and its urinary metabolites, finding no evidence of toxicity. One study noted that glutathione levels decreased but not to clinically deficient levels. Administration of acetaminophen plus morphine versus morphine alone did not increase adverse events and a morphine sparing effect of acetaminophen was demonstrated in two studies.
Conclusion: Use of acetaminophen for adult patients undergoing liver resection surgery as post-operative analgesia at a standard dosage is safe for baseline analgesia. All studies analysed support that toxicity is not reached; and that acetaminophen provides a morphine sparing effect without adverse effects. Acetaminophen dose reduction should be considered in patients where extra risk factors for hepatotoxicity are present.
Background: This study compared short- and mid-term outcomes of hemihepatectomy (HH) and pancreatoduodenectomy (PD) in patients with extrahepatic cholangiocarcinoma, focusing on surgical outcomes, body composition, and nutritional status.
Method: A retrospective review was conducted to assess short-term outcomes, including operative time, blood loss, complications, and mortality. Body composition and nutritional parameters were analyzed preoperatively and 1 year postoperatively.
Background And Aims: Hepatocellular carcinoma (HCC) exhibits a propensity for early recurrence following liver resection, resulting in a bleak prognosis. At present, majority of the predictive models for the early postoperative recurrence of HCC rely on the linear assumption of the Cox Proportional Hazard (CPH) model. However, the predictive efficacy of this model is constrained by the intricate nature of clinical data.
Background: Frailty has been associated with increased mortality and complications among liver cancer patients. However, the frailty prevalence and outcomes in frail populations with primary liver cancer have not been systematically validated.
Methods: Embase, PubMed, Scopus, and Web of Science were searched for eligible studies that explored the prevalence and impact of frailty in liver cancers from inception until October 26, 2023.
