Ann Hepatobiliary Pancreat Surg.  2018 Nov;22(4):344-349. 10.14701/ahbps.2018.22.4.344.

A cohort study on the risk of hepatectomy and pancreatectomy after history of abdominal surgery on other organs

Affiliations
  • 1Division of Hepato-biliary-pancreas Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan. a_nanashima@med.miyazaki-u.ac.jp
  • 2Division of Gastrointestinal, Endocrine and Pediatric Surgery, Department of Surgery, University of Miyazaki Faculty of Medicine, Miyazaki, Japan.

Abstract

BACKGROUNDS/AIMS
The present study analyzed the postoperative outcomes in patients who underwent hepatectomy or pancreatectomy, with a history of intra-abdominal surgery involving other organs, to elucidate surgical efficacy.
METHODS
We examined the perioperative parameters in 28 patients who underwent hepatectomy (n=12) and pancreatectomy (n=16) after receiving prior abdominal organ resection (esophagectomy, n=2; gastrectomy, n=5; resection of small intestine, n=2; appendectomy, n=5; colorectal resection, n=9; hepatectomy, n=1; cholecystectomy, n=3; splenectomy, n=2, pancreatectomy ,right adrenectomy, nephrectomy and myoma uteri, n=1 each).
RESULTS
Age, gender, a history of comorbidities, and primary diseases were not significantly different between the groups. The present operation was predominantly indicated for liver metastases in all patients undergoing hepatectomy. Several diseases were detected in pancreaticoduodenectomy (PD) patients. Laboratory data were not significantly different between groups. Although operating time and blood loss during hepatectomy did not differ significantly between the groups, the operating time was significantly longer in patients undergoing PD compared with distal pancreatectomy (p < 0.05). Red cell blood transfusion was most frequently used in patients who underwent major hepatectomy and PD (p < 0.05). The prevalence of postoperative complications was not significantly different between groups. Hospital death was not observed and the period of hospital stay did not differ between groups.
CONCLUSIONS
Carefully scheduled hepatectomy or pancreatectomy is safe even in cases with prior abdominal surgery under the present strategy.

Keyword

Hepatectomy; Pancreatectomy, Previous history; Abdominal surgeries; Operative difficulties

MeSH Terms

Appendectomy
Blood Transfusion
Cholecystectomy
Cohort Studies*
Comorbidity
Gastrectomy
Hepatectomy*
Humans
Intestine, Small
Length of Stay
Liver
Myoma
Neoplasm Metastasis
Nephrectomy
Pancreatectomy*
Pancreaticoduodenectomy
Postoperative Complications
Prevalence
Splenectomy
Uterus

Reference

1. Mavros MN, Velmahos GC, Lee J, Larentzakis A, Kaafarani HM. Morbidity related to concomitant adhesions in abdominal surgery. J Surg Res. 2014; 192:286–292. PMID: 25151471.
Article
2. Kim JH, Min SK, Lee H, Hong G, Lee HK. The safety and risk factors of major hepatobiliary pancreatic surgery in patients older than 80 years. Ann Surg Treat Res. 2016; 91:288–294. PMID: 27904850.
Article
3. Okabayashi K, Ashrafian H, Zacharakis E, Hasegawa H, Kitagawa Y, Athanasiou T, et al. Adhesions after abdominal surgery: a systematic review of the incidence, distribution and severity. Surg Today. 2014; 44:405–420. PMID: 23657643.
Article
4. Golfinopoulos V, Pentheroudakis G, Pavlidis N. Treatment of colorectal cancer in the elderly: a review of the literature. Cancer Treat Rev. 2006; 32:1–8.
Article
5. Nanashima A, Abo T, Nonaka T, Hidaka S, Takeshita H, Morisaki T, et al. Comparison of postoperative morbidity in elderly patients who underwent pancreatic resection. Hepatogastroenterology. 2012; 59:1141–1146. PMID: 22580667.
6. Nanashima A, Abo T, Nonaka T, Fukuoka H, Hidaka S, Takeshita H, et al. Prognosis of patients with hepatocellular carcinoma after hepatic resection: are elderly patients suitable for surgery? J Surg Oncol. 2011; 104:284–291. PMID: 21462192.
Article
7. Panis Y, Maggiori L, Caranhac G, Bretagnol F, Vicaut E. Mortality after colorectal cancer surgery: a French survey of more than 84,000 patients. Ann Surg. 2011; 254:738–743. PMID: 21997816.
8. Al-Refaie WB, Parsons HM, Habermann EB, Kwaan M, Spencer MP, Henderson WG, et al. Operative outcomes beyond 30-day mortality: colorectal cancer surgery in oldest old. Ann Surg. 2011; 253:947–952. PMID: 21490452.
9. Yamamoto S, Watanabe M, Hasegawa H, Baba H, Kitajima M. Short-term surgical outcomes of laparoscopic colonic surgery in octogenarians: a matched case-control study. Surg Laparosc Endosc Percutan Tech. 2003; 13:95–100. PMID: 12709614.
10. Masoomi H, Moghadamyeghaneh Z, Mills S, Carmichael JC, Pigazzi A, Stamos MJ. Risk factors for conversion of laparoscopic colorectal surgery to open surgery: does conversion worsen outcome? World J Surg. 2015; 39:1240–1247. PMID: 25631940.
Article
11. Kim IY, Kim BR, Kim YW. Impact of prior abdominal surgery on rates of conversion to open surgery and short-term outcomes after laparoscopic surgery for colorectal cancer. PLoS One. 2015; 10:e0134058. PMID: 26207637.
Article
12. Yamamoto M, Okuda J, Tanaka K, Kondo K, Asai K, Kayano H, et al. Effect of previous abdominal surgery on outcomes following laparoscopic colorectal surgery. Dis Colon Rectum. 2013; 56:336–342. PMID: 23392148.
Article
13. Pack GT, Baker HW. Total right hepatic lobectomy; report of a case. Ann Surg. 1953; 138:253–258. PMID: 13066016.
14. Donadon M, Costa G, Gatti A, Torzilli G. Thoracoabdominal approach in liver surgery: how, when, and why. Updates Surg. 2014; 66:121–125. PMID: 24338089.
Article
15. Kubota K. Right hepatic lobectomy with thoracotomy: a description (with video). J Hepatobiliary Pancreat Sci. 2012; 19:30–37. PMID: 21935620.
Article
16. Nanashima A, Sumida Y, Tobinaga S, Shindo H, Shibasaki S, Ide N, et al. Advantages of thoracoabdominal approach by oblique incision for right-side hepatectomy. Hepatogastroenterology. 2007; 54:148–151. PMID: 17419250.
17. Faber W, Seehofer D, Neuhaus P, Stockmann M, Denecke T, Kalmuk S, et al. Repeated liver resection for recurrent hepatocellular carcinoma. J Gastroenterol Hepatol. 2011; 26:1189–1194. PMID: 21410751.
Article
18. Ejaz A, Spolverato G, Kim Y, Wolfgang CL, Hirose K, Weiss M, et al. The impact of resident involvement on surgical outcomes among patients undergoing hepatic and pancreatic resections. Surgery. 2015; 158:323–330. PMID: 26003913.
19. Cocieru A, Saldinger PF. HPB surgery can be safely performed in a community teaching hospital. J Gastrointest Surg. 2010; 14:1853–1857. PMID: 20480255.
Article
20. Nanashima A, Sumida Y, Abo T, Tanaka K, Takeshita H, Hidaka S, et al. Principle of perioperative management for hepatic resection and education for young surgeons. Hepatogastroenterology. 2008; 55:587–591. PMID: 18613413.
21. Sumida Y, Nanashima A, Abo T, Tobinaga S, Araki M, Kunizaki M, et al. Stepwise education for pancreaticoduodenectomy for young surgeons at a single Japanese institute. Hepatogastroenterology. 2010; 57:1046–1051. PMID: 21410029.
22. Chen JY, Feng J, Wang XQ, Cai SW, Dong JH, Chen YL. Risk scoring system and predictor for clinically relevant pancreatic fistula after pancreaticoduodenectomy. World J Gastroenterol. 2015; 21:5926–5933. PMID: 26019457.
Article
23. Nanashima A, Abo T, Hamasaki K, Wakata K, Kunizaki M, Nakao K, et al. Predictive parameters of intraoperative blood loss in patients who underwent pancreatectomy. Hepatogastroenterology. 2013; 60:1217–1221. PMID: 23803385.
Full Text Links
  • AHBPS
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr