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Updated: Apr 26, 2026
Laparoscopic Anterior Right Hepatectomy: A Single-Center Experience
Published on: December 4, 2023
Post-hepatectomy haemorrhage: a single-centre experience
Aijun Li1, Bin Wu, Weiping Zhou
1Eastern Hepatobiliary Surgery Hospital, Second Military Medical University, Shanghai, China.
Objectives:
This study aimed to explore the incidence and causes of intra-abdominal haemorrhage after hepatectomy, indications for re-exploration, and factors affecting occurrence.
Methods:
Clinical data for 77 patients (0.2% of 32 856 hepatectomy patients) submitted to re-exploration for haemorrhage following hepatectomy for primary liver cancer (PLC) from 2001 to 2010 were retrospectively reviewed and analysed for postoperative complications, potential site and cause of bleeding.
Results:
The median interval between hepatectomy and re-exploration was 23 h in the 77 patients (range: 1 h to 11 days). Re-exploration occurred within 24 h after hepatectomy in 64 patients (83.1%), and within 8 h in 37 patients (48.1%). The most common anatomic site of intra-abdominal haemorrhage was the cut surface of the liver (n = 51, 66.2%), followed by the perihepatic ligaments (n = 19, 24.7%), the splenic fossa (n = 7, 9.1%), the diaphragm (n = 6, 7.8%), the retroperitonium (n = 6, 7.8%), the right adrenal gland (n = 3, 3.9%), and the gallbladder bed (n = 2, 2.6%). The most common form of bleeding was oozing. Early haemorrhage (at ≤ 24 h) was most likely to occur in the form of venous bleeding or oozing from the cut surface of the liver. Rates of 5-year overall and disease-free survival in the 77 patients were 22.1% and 3.9%, respectively.
Conclusions:
Re-exploration for haemorrhage following hepatectomy for PLC is a rare event. Haemorrhage occurs predominantly at the cut parenchymal surface. Early return to the operating room is vital and perioperative survival is common in this high-risk group.
