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Assessment of blood‐products use as predictor of pulmonary complications and surgical‐site infection after hepatectomy for hepatocellular carcinoma
Author(s) -
Shiba Hiroaki,
Ishii Yuji,
Ishida Yuichi,
Wakiyama Shigeki,
Sakamoto Taro,
Ito Ryusuke,
Gocho Takeshi,
Uwagawa Tadashi,
Hirohara Shoichi,
Kita Yoshiaki,
Misawa Takeyuki,
Yanaga Katsuhiko
Publication year - 2009
Publication title -
journal of hepato‐biliary‐pancreatic surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.63
H-Index - 60
eISSN - 1868-6982
pISSN - 0944-1166
DOI - 10.1007/s00534-008-0006-1
Subject(s) - medicine , hepatectomy , fresh frozen plasma , hepatocellular carcinoma , albumin , perioperative , surgery , gastroenterology , serum albumin , prothrombin time , univariate analysis , blood transfusion , platelet , multivariate analysis , resection
Background In perioperative management after hepatectomy, some patients require fresh frozen plasma (FFP) to treat coagulopathy associated with blood loss. However, several studies have suggested a correlation between blood products and pulmonary complications or surgical‐site infection (SSI). Methods The subjects were 99 patients who underwent hepatectomy for hepatocellular carcinoma without plasma exchange for postoperative liver failure in the Department of Surgery, Jikei University Hospital, between January 2000 and December 2006. We investigated the association of 16 factors including age; gender; preoperative ICG R15 ; type of resection; concomitant resection of other digestive organs; duration of operation; blood loss; hepatitis virus status; postoperative minimum platelet count, maximum serum total bilirubin (max T‐Bil), minimum serum albumin, or minimum prothrombin time; and the dose of red‐blood‐cell concentration (RC), FFP, platelet concentration, or albumin given in relation to postoperative pulmonary complications and SSI. Results In univariate analysis, pulmonary complications were correlated with gender ( P = 0.012), max T‐Bil ( P = 0.043), dose of RC given ( P = 0.007), dose of FFP given ( P < 0.001), and dose of albumin given ( P < 0.001). In multivariate analysis, pulmonary complications were correlated with FFP given ( P = 0.031) and albumin given ( P = 0.020), while the incidence of SSI was not correlated with any factors. Conclusion Excessive FFP and albumin administration may cause pulmonary complications after hepatectomy.