Liver dysfunction and sepsis determine operative mortality after liver resection

Felice Giuliante, Gennaro Nuzzo, Ivo Giovannini, Lorenzo Capussotti, Luca Viganò, Alessandro Ferrero

Research output: Contribution to journalArticlepeer-review

56 Citations (Scopus)

Abstract

Background: Liver failure is the principal cause of death after hepatectomy. Its progression towards death and its relationship with sepsis are unclear. This study analysed predictors of mortality in patients with liver dysfunction and the role of sepsis in the death of these patients. Methods: The study focused on patients with liver dysfunction, excluding those with vascular thrombosis, after liver resection at one of two centres between 1998 and 2006. Results: Liver dysfunction occurred after 57 (4.5 per cent) of 1271 hepatectomies. Fifty-three patients without vascular thrombosis were included in the analysis, with a mortality rate of 23 per cent. Independent predictors of death were age (odds ratio (OR) 1.18 per year increase; P = 0.017), cirrhosis (OR 54.09; P = 0.004) and postoperative sepsis (OR 37.58; P = 0.005). Sepsis occurred in 15 patients (28 per cent), seven of whom died. Intestinal pathogens were isolated in 12 patients with sepsis. The risk of sepsis was significantly increased in those with surgical complications (11 of 16 versus four of 37; P < 0.001). Conclusion: Sepsis plays a key role in the death of patients with liver dysfunction after hepatectomy.
Original languageEnglish
Pages (from-to)88-94
Number of pages7
JournalBritish Journal of Surgery
Volume96
DOIs
Publication statusPublished - 2009

Keywords

  • Diagnosis
  • Liver insufficiency
  • Liver resection
  • Morbidity
  • Mortality
  • Postoperative complications
  • Sepsis

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