Clinical study of hepatic damage during perioperative period of liver resection for hepatic carcinoma in elderly patients / 中华老年医学杂志

ABSTRACT

Objective To investigate the causes and preventive measures of hepatic failure during perioperative period of liver resection for primary hepatic carcinoma in the elderly patients, and to explore its diagnosis and treatment. Methods The 62 patients with primary hepatic carcinoma undergoing hepatectomy were analyzed retrospectively, and they were divided into two groups elderly group (age≥60 years) and non-elderly group (age＜60 years). The influencing factors for damage of hepatic function were analyzed using single variant and multivariate stepwise regression analysis in elderly and non-elderly group, pringle maneuver and non-pringle maneuver group, more (≥500 ml)and less (＜500 ml) amount of bleeding group. Results The incidence of hepatic damage and mortality rate induced by hepatic failure were 32. 6% and 1.6% respectively after liver resection for primary hepatic carcinoma. Single variant analysis showed that pringle maneuver, intraoperative blood loss, blood transfusion and size of tumor were associated with postoperative hepatic function.Furthermore, multivariate stepwise regression analysis revealed that pringle maneuver was the independent risk factor associated with postoperative hepatic function (β = 0. 314, t= 2. 272, P ＜0. 05). Conclusions The postoperative hepatic damage is significantly correlated with pringle maneuver and intraoperative bleeding in liver resection for hepatocellular carcinoma in senile people.And improving operative techniques, shorting the time of pringle maneuver, decreasing intraoperative bleeding were the main preventive measures for hepatic damage after liver resection for primary hepatic carcinoma in the elderly patients.