Renal function after elective hepatic resection

Although morbidity and mortality associated with liver surgery has declined, in particular operative death from liver failure, accumulation of fluid in the peritoneal or pleural cavities after hepatic resection is still the most common post-operative complication and it often decreases the patient's quality of life. The purpose of this retrospective review is to discuss the effect of renal dysfunction following hepatic resection on ascites formation in patients who underwent hepatic resection.

The patients who underwent hepatectomy were assigned to two groups; Group A patients (n = 119) had some form of ascites or pleural effusion, either intractable or easily controlled, while Group B patients (n = 178) had neither ascites nor pleural effusion. We compared the clinical and laboratory data, operative risk factors, and the post-operative renal as well as hepatic functions of the two groups.

In addition to ordinary risk factors associated with ascites formation such as decreased plasma oncotic pressure due to hypoalbuminemia along with increased hydrostatic pressure in the portal circulation, renal dysfunction after hepatic resection might be the primary cause of fluid accumulation in the peritoneal cavity.

As one of the mechanisms of ascites formation following hepatic resection, we must consider the presence of renal dysfunction and protect against ascites formation and treat refractory ascites after hepatic resection not only by such traditional methods such as water and salt restriction, the use of diuretics, and the infusion of albumin products, but also by preserving the renal function after hepatectomy.