One hundred hepatic resections. Indications and operative results

The indications and operative results of hepatic resections were investigated in 100 consecutive patients over the past 20 years. There were 61 hepatocellular carcinoma, 13 hepatolithiasis, and 26 other miscellaneous diseases. An overall hospital mortality rate was 25%. It was 26, 0, and 35% in patients with hepatocellular carcinoma, hepatolithiasis, and other diseases, respectively. There was not any significant difference between survived and deceased cases in their preoperative laboratory data. The volume of operative blood loss in deceased cases was significantly larger than that in survived cases, so the influence of operative blood loss on morbidity and mortality was investigated. The incidences of postoperative bleeding, hepatic insufficiency, pulmonary insufficiency, and hospital death were significantly higher in patients whose operative blood loss exceeded 5000 ml. These results indicate that operative blood loss is one of the critical factors that decide the operative prognosis.