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Disseminated intravascular coagulation after hepatic resection
T Tsuzuki1, K Toyama, K Nakayasu
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
Surgery
|February 1, 1990
Summary
Disseminated intravascular coagulation (DIC) following liver resection is a severe complication. Prompt treatment with gabexate mesilate shows promise in managing this condition and improving patient outcomes.
Area of Science:
- Hepatobiliary Surgery
- Hematology
- Critical Care Medicine
Background:
- Disseminated intravascular coagulation (DIC) is a life-threatening complication post-hepatic resection.
- Early diagnosis and intervention are crucial for patient survival.
Observation:
- A study reviewed 192 patients undergoing hepatic resection between 1973 and 1988, with 18 developing postoperative DIC.
- Diagnostic criteria included platelet count, fibrinogen levels, fibrin degradation products (FDP), and the protamine sulfate test.
Findings:
- Heparin use was discontinued due to dosing challenges in liver resection patients.
- Gabexate mesilate, an anticoagulant independent of antithrombin III, is now employed.
- Fifteen patients recovered, while three succumbed to DIC aggravation or liver failure.
Implications:
- Gabexate mesilate represents a viable treatment option for DIC post-hepatic resection.
- Further research into optimizing DIC management strategies in liver surgery patients is warranted.
- Understanding DIC pathophysiology is key to improving surgical outcomes in hepatobiliary diseases.