Postoperative Hemorrhage After Hepatic Resection

Abstract

Between 1992 and 2000, 313 hepatic resections without choledocojejunal anastomosis were performed atour institute. Postoperative hemorrhage developed in 6 patients (1.9%). Reoperation was performed in 4patients, and follow-up therapy was chosen in 2, in whom hepatic failure developed, and one of whom, diedwithin three months of the operation. Postoperative hemorrhage was closely related to intraoperativebleeding, operative time, and the weight of the specimen. Bleeding points were the cut surface of the liver, adrenal grand, diaphragm, and sternum. To prevent postoperative hemorrhage, fresh frozen protein (FFP) and vitamin K were preopratively administered in patients with coagulopathy, and efforts should be madeto decrease the average blood loss and transfusion requirement. Confirmation of hemostasis is absolutelyand constantly required intraoperatively. Reoperation for hemostasis should be undertaken as soon aspossible when the volume of blood loss has not decreased within a few hours postoperatively, regardless ofwhether the amount of blood loss is small or large.