Sepsis after liver resection: Predisposition, clinical relevance and synergism with liver dysfunction

Gennaro Nuzzo, Felice Giuliante, Francesco Ardito, Ivo Giovannini, Carlo Chiarla

Risultato della ricerca: Contributo in libroChapter

Abstract

Liver resection, compared with other abdominal operations, is characterized by greater predisposition to septic complications. This may be explained by several factors, including the major role of the liver in immune defence, anatomical features such as the close relationship of the hepato‑biliary system with the intestine, underlying liver disease if present and specific preoperative treatments favouring postoperative sepsis. A critical point is that sepsis does not always present with immediately recognizable signs, such as fever or leukocytosis. At times it presents with more subtle signs, for instance hyperbilirubinemia and encephalopathy. After liver resection these may be misinterpreted as simple consequences of transient parenchymal insufficiency, therefore resulting in failure to recognize and promptly treat underlying sepsis. Particular caution is needed in this setting to avoid dismal outcomes. This chapter focuses on these aspects, describing underlying mechanisms and preventive measures and further characterizing the powerful synergism of sepsis overimposed on postoperative liver dysfunction in determining poor outcome.
Lingua originaleEnglish
Titolo della pubblicazione ospiteRecent Advances in Liver Surgery
EditorRenzo Dionigi
Pagine245-259
Numero di pagine15
Stato di pubblicazionePubblicato - 2008

Keywords

  • Hyperbilirubinemia
  • Hypocholesterolemia
  • Intensive care
  • Liver insufficiency
  • Liver ischemia
  • Liver resection
  • Morbidity
  • Mortality
  • Pathophysiology
  • Predisposition
  • Sepsis

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