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Major abdominal cancer resections in cirrhotic patients: How frequent is postoperative hepatocellular decompensation?

Indian Journal of Gastroenterology volume 33, pages 258–264 (2014)Cite this article

Abstract

Background

The reported incidence of postoperative liver failure in cirrhotic patients is highly varied with diverse risk factors identified to predict risk, mainly drawn from organ or disease-specific studies. We aimed to assess risk factors for the development of postoperative liver failure in a specific cohort of patients with cirrhosis undergoing abdominal cancer resection.

Methods

From November 2007 to October 2012, 30 cirrhotic patients who underwent curative resection for abdominal cancer were analyzed. The postoperative trends in liver function were followed and the incidence of postoperative liver failure was demonstrated.

Results

Among the 30 patients, the tumors were located in the stomach (n = 5), pancreas (n = 5), colon/rectum (6), liver (n = 11), gallbladder (n = 1), and retroperitoneum (n = 2). Eighteen (60 %) patients experienced postoperative liver failure of which 7 (23 %) patients required deviation from the clinical course or management. There was one mortality due to grade C liver failure and hepatorenal syndrome. On multivariate analysis, only age (>55 years) was found to be statistically significant to predict postoperative liver failure (p = 0.024).

Conclusion

Liver dysfunction remains a major problem during the postoperative phase of major gastrointestinal cancer resections. However, less than one fourth of well-selected patients will develop significant postoperative liver failure. This incidence may be further reduced if the selection is restricted to younger patients.

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Affiliations

  1. Division of Gastrointestinal and Hepato-Pancreato-Biliary Surgical Oncology, Tata Memorial Centre, Parel, Mumbai, 400 012, India

    Shailesh Vinayak Shrikhande, Vinay Gaikwad & Mahesh Goel

  2. Department of Gastrointestinal Surgery, Choithram Hospital and Research Centre, Manik Bagh Road, Indore, 452 014, India

    Dipak Purohit

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  1. Shailesh Vinayak Shrikhande
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  2. Vinay Gaikwad
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  3. Dipak Purohit
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  4. Mahesh Goel
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Correspondence to Shailesh Vinayak Shrikhande.

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Shrikhande, S.V., Gaikwad, V., Purohit, D. et al. Major abdominal cancer resections in cirrhotic patients: How frequent is postoperative hepatocellular decompensation?. Indian J Gastroenterol 33, 258–264 (2014). https://doi.org/10.1007/s12664-013-0426-y

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  • DOI: https://doi.org/10.1007/s12664-013-0426-y

Keywords

  • Complications
  • Liver disease
  • Liver failure
  • Surgery