Intraabdominal abscess formation after major liver resection.

Acta chirurgica Scandinavica Pub Date : 1990-10-01
R Andersson, A Saarela, K G Tranberg, S Bengmark
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Abstract

A series of 138 major liver resections undertaken between 1971 and 1987 were reviewed. Intrabdominal abscesses developed in 11 (8%) patients, a mean of 23 days (range 10-42) after operation and two died (mortality 18%). Eight developed after 63 right hepatectomies, two after 24 right lobectomies, one after 34 left hepatectomies and none after left lobectomies (17). Patients who developed intra-abdominal abscesses underwent significantly longer operations (mean (SEM) 400 (48) compared with 275 (21) min) (p less than 0.05) and had significantly more bleeding during the operation (7,600 (1,750) compared with 3,200 (430), p less than 0.01) than those who did not. The amounts recovered from the abdominal drains, both before and after the diagnosis, were comparatively greater in patients with abdominal abscesses. Antibiotic prophylaxis was given to 10 of 11 patients who did and 89 of 127 patients who did not, form abscesses. We conclude that the risk of intra-abdominal abscess formation after major liver resection is increased: when a large amount of liver tissue is removed (right hepatectomy or lobectomy); when there is a lot of intraoperative bleeding; and when the operation takes a long time. Antibiotic prophylaxis did not affect the risk of abscess formation this series.

肝大部切除后腹内脓肿形成。
本文回顾了1971年至1987年间进行的138例肝切除术。11例(8%)患者出现腹腔内脓肿,平均术后23天(10-42天),2例死亡(死亡率18%)。8例发生在63例右肝切除术后,2例发生在24例右肝切除术后,1例发生在34例左肝切除术后,无一例发生在左肝切除术后(17)。发生腹内脓肿的患者手术时间明显更长(平均(SEM) 400(48)比275(21)分钟)(p < 0.05),术中出血明显更多(7600(1750)比3200 (430),p < 0.01)。腹腔脓肿患者在诊断前和诊断后,腹腔引流液的回收量相对较大。11例有脓肿的患者中有10例给予抗生素预防,127例没有脓肿的患者中有89例给予抗生素预防。我们得出结论,肝大切除术后腹内脓肿形成的风险增加:当大量肝组织被切除时(右肝切除术或肺叶切除术);术中大量出血时;当手术需要很长时间时。抗生素预防不影响脓肿形成的风险。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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