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Eleven Cases of Postoperative Hepatic Infarction Following Pancreato-Biliary Surgery

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Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Postoperative hepatic infarction is rare; therefore, clinical characteristics and outcomes of postoperative hepatic infarction after pancreatobiliary surgery have not been obvious.

Methods

Eleven patients encountered hepatic infarction after pancreato-biliary surgery. Management, clinical course, and outcome of these 11 patients were retrospectively analyzed.

Results

Possible causes of the hepatic infarction were inadvertent injury of the hepatic artery during lymph node dissection in five patients, right hepatic artery ligation in two patients, long-term clamp of the hepatic artery during hepatic arterial reconstruction in two patients, suturing for bleeding from the right hepatic artery in one patient, and celiac axis compression syndrome in one patient. Five of the 17 infarcts extended for one whole section of the liver, and distribution of the other 12 was less than one section. Ten patients discharged from hospital; however, one patient died of sepsis of unknown origin.

Conclusions

Attention should be paid to inadvertent injury of hepatic artery to prevent hepatic infarction. Hepatic infarctions after pancreato-biliary surgery seldom extend to the entire liver and most of them are able to be treated without intervention.

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Abbreviations

TACE:

Transcatheter arterial chemoembolization

RFA:

Radiofrequency ablation

TIPS:

Transjugular intrahepatic portosystemic shunt

AST:

Aspartate aminotransferase

ALT:

Alanine aminotransferase

PE:

Plasma exchange

CHDF:

Continuous hemodiafiltration

ARDS:

Acute respiratory distress syndrome

RCT:

Randomized controlled trial

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Authors and Affiliations

  1. Department of Surgery, Teikyo University School of Medicine, 2-11-1, Kaga, Itabashi-ku, Tokyo, 173–8605, Japan

    Fumihiko Miura, Takehide Asano, Hodaka Amano, Masahiro Yoshida, Naoyuki Toyota, Keita Wada, Kenichoro Kato, Koichi Hayano, Susumu Kadowaki, Makoto Shibuya, Sawako Maeno & Tadahiro Takada

  2. Department Plastic Surgery, Teikyo University School of Medicine, Tokyo, Japan

    Tomoaki Eguchi

Authors
  1. Fumihiko Miura
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  2. Takehide Asano
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  3. Hodaka Amano
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  4. Masahiro Yoshida
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  5. Naoyuki Toyota
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  6. Keita Wada
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  7. Kenichoro Kato
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  8. Koichi Hayano
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  9. Susumu Kadowaki
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  10. Makoto Shibuya
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  11. Sawako Maeno
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  12. Tadahiro Takada
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  13. Tomoaki Eguchi
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Corresponding author

Correspondence to Takehide Asano.

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Miura, F., Asano, T., Amano, H. et al. Eleven Cases of Postoperative Hepatic Infarction Following Pancreato-Biliary Surgery. J Gastrointest Surg 14, 352–358 (2010). https://doi.org/10.1007/s11605-009-1089-y

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  • DOI: https://doi.org/10.1007/s11605-009-1089-y

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