COMPLICATIONS AFTER HEPATECTOMY.

Claudemiro Quireze Junior, Fabricio Ferreira Coelho, Agnaldo Soares Lima, Hugo Pinto Marques, Martin Palavecino, Timothy Pawlik, Rene Adam, Olivier Soubrane, Paulo Herman, Ricardo Lemos Cotta-Pereira
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Abstract

Complete removal of metastatic disease and maintenance of an adequate liver remnant remains the only treatment option with curative intent concerning colorectal liver metastases. Surgery impacts on the long-term prognosis and complications adversely affect oncological results. The actual morbidity involving this scenario is debatable and estimated to be ranging from 15% to 50%. Postoperative complications eventually lead to an increase in both mortality rates and tumor recurrence. Biliary fistula and liver failure are the leading complications following liver resection to metastatic colorectal cancer. Prophylactic drainage does not prevent fistulas or hemorrhage. Drainage along with endoscopic intervention and/or surgery may be necessary for grade B and C fistulas. Liver failure is a potentially lethal complication with few therapeutic options. Patient selection and preoperative care are crucial for its prevention.

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肝切除术后的并发症。
完全去除转移性疾病和维持足够的肝脏残余仍然是治疗结肠直肠肝转移的唯一选择。手术对远期预后的影响和并发症对肿瘤结果有不利影响。涉及这种情况的实际发病率是有争议的,估计在15%到50%之间。术后并发症最终导致死亡率和肿瘤复发率的增加。胆道瘘和肝功能衰竭是转移性结直肠癌肝切除术后的主要并发症。预防性引流不能预防瘘管或出血。对于B级和C级瘘管,可能需要引流并进行内镜干预和/或手术。肝功能衰竭是一种潜在的致命并发症,几乎没有治疗选择。患者选择和术前护理是预防该病的关键。
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