Clinical, Laboratory, and Perioperative Management Characteristics in Liver Resection Cases in Fatmawati General Hospital

Nikko Darnindro, J. Marsigit, A. Nugroho, A. Sari, M. Taufik, Dieby Adrisyel, Elisabeth Yasmine Wardoyo, Apriliana Ratnaningrum, Danny Darmawan
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引用次数: 0

Abstract

Background: Liver resection has been associated with high morbidity and mortality. Improvements in surgical, anesthetic techniques, and multidisciplinary collaborations, can reduce post-surgery complications and mortality. This study aims to provide an overview of the perioperative conditions and the treatments after liver resection.Method: A retrospective study of liver resection surgery between 2019-2020 at Fatmawati Hospital.Results: Of the 11 patients, mean age was 49.7 years, with 63.6% being female and mean BMI was 22 kg/m2, hypertension and diabetes mellitus were found in 18.2% and 18.2% of patients respectively. HBsAg reactive was detected in 36.3%. Based on pathology, HCC was found in 54.5%, while 18.2% were metastatic adenocarcinoma. Postoperative hyperglycemia was observed in 90.9%. Increase in AST and ALT 3 upper limit normal were found in 90% and 72.7% of patients. Mean AST and ALT were 408.3 U/L and 246.18 U/L. Mean urine production at 8-, 16-, 24-, and 48-hours post-operative were 757, 1624, 1880 and 1930 cc. Urine production ≤ 500 cc in the first 8 hours was detected in 44.4% of patients, and elevated creatinine levels 50% post-operative occurred at 11.1%, 22.2%, 22.2% at 16, 24, and 48 hours post-op. Renal support therapy was given to 5 of the 11 patients. D-Dimer levels were increased in all patients.Conclusion: Adequate fluid monitoring and metabolic disorders control such as glucose levels, acute kidney injury, coagulation disorders, and bleeding are important things that need to be considered in the perioperative management of liver resection.
法塔玛瓦蒂总医院肝切除术病例的临床、实验室和围手术期处理特点
背景:肝切除术与高发病率和死亡率相关。手术、麻醉技术和多学科合作的改进可以减少术后并发症和死亡率。本研究旨在综述肝切除术后围手术期情况及治疗。方法:回顾性研究2019-2020年法塔玛瓦蒂医院肝切除手术。结果:11例患者中,平均年龄49.7岁,女性占63.6%,平均BMI为22 kg/m2,高血压和糖尿病分别占18.2%和18.2%。HBsAg阳性检出率为36.3%。病理结果显示,HCC占54.5%,转移性腺癌占18.2%。术后出现高血糖的占90.9%。90%和72.7%的患者AST和ALT 3上限正常增高。AST、ALT均值分别为408.3 U/L、246.18 U/L。术后8、16、24和48小时的平均尿量分别为757、1624、1880和1930 cc。44.4%的患者在前8小时尿量≤500cc,术后肌酐水平升高50%的患者在术后16、24和48小时分别为11.1%、22.2%和22.2%。11例患者中5例给予肾支持治疗。所有患者的d -二聚体水平均升高。结论:充分的液体监测和代谢紊乱的控制,如血糖水平、急性肾损伤、凝血功能障碍和出血,是肝切除术围手术期管理中需要考虑的重要问题。
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