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Major liver resection without a blood transfusion: is it a realistic objective?
G G Jamieson1, L Corbel, J P Campion
1Centre for Digestive Surgery, Hospital Pontchaillou, Rennes, France.
Background:
Observations from 75 patients undergoing resection of the liver during a recent period have been analyzed with respect to the use of perioperative blood transfusions and operative outcome.
Methods:
Twenty-six patients were operated on for benign disease and 49 patients for malignant disease. Twenty-one patients underwent a right or left hepatectomy, 49 patients underwent removal of one or more anatomic segments of the liver, and five patients underwent wedge resection of a lesion in the liver. There was one postoperative death.
Results:
The median blood loss was 0 units (range, 0 to 15 units). Sixty-three percent of the patients underwent operation without the need for a blood transfusion. The median postoperative stay was 10 days (range, 4 to 88 days). In the group of patients who did not undergo a blood transfusion the median postoperative stay was 9 days (range, 4 to 28 days), and in the patients who had a blood transfusion it was 14 days (range, 6 to 84 days) (p less than 0.0003).
Conclusions:
The performance of major liver resection without a blood transfusion is a realistic objective.