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Published in:

01-10-2013

Risk Factors of Hospital Mortality after Re-laparotomy for Post-hepatectomy Hemorrhage

Authors: Tian Yang, Li Li, Qian Zhong, Wan Yee Lau, Han Zhang, Xing Huang, Wei-Feng Yu, Feng Shen, Jie-Wei Li, Meng-Chao Wu

Published in: World Journal of Surgery | Issue 10/2013

Abstract

Background

Post-hepatectomy hemorrhage (PHH) requiring re-laparotomy is a life-threatening situation and is associated with a considerably high hospital mortality rate. However, risk factors of hospital mortality in patients with this condition have not yet been investigated.

Methods

The perioperative data of 258 patients with hepatocellular carcinoma who underwent re-laparotomy for PHH from 1997 to 2011 were retrospectively reviewed and evaluated by univariate and multivariate analyses to identify risk factors of hospital mortality.

Result

Hospital death occurred in 43 patients between 16 h and 40 days after re-laparotomy, and the overall mortality rate was 16.7 %. The median time lag between first recognition of active bleeding and re-laparotomy was 6 h (range 0.5–34 h). The mortality of patients undergoing late re-laparotomy (≥6 h) was much higher than those undergoing early re-laparotomy (<6 h) (25 vs 8.6 %; P = 0.001). Multivariate analysis showed early time period (1997–2004) (P = 0.040), liver cirrhosis (P = 0.025), ineffective hemostasis during re-laparotomy due to coagulopathy (P = 0.038), late re-laparotomy (≥6 h) (P = 0.032), postoperative liver failure (P = 0.001), and postoperative acute renal failure requiring hemodialysis (P = 0.024) were independent risk factors of hospital mortality.

Conclusion

Immediate re-laparotomy is a key factor to reduce hospital mortality for patients with active bleeding after partial hepatectomy. More care should be taken in those patients who develop acute liver failure and/or serious acute renal failure after re-laparotomy.

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Title: Risk Factors of Hospital Mortality after Re-laparotomy for Post-hepatectomy Hemorrhage
Authors: Tian Yang
Li Li
Qian Zhong
Wan Yee Lau
Han Zhang
Xing Huang
Wei-Feng Yu
Feng Shen
Jie-Wei Li
Meng-Chao Wu
Publication date: 01-10-2013
Publisher: Springer US
Published in: World Journal of Surgery / Issue 10/2013
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-013-2147-x

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Risk Factors of Hospital Mortality after Re-laparotomy for Post-hepatectomy Hemorrhage

Abstract

Background

Methods

Result

Conclusion

At a glance: The ONWARDS insulin icodec trials

Springer Medicine

Abstract

Background

Methods

Result

Conclusion

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