Abstract
A case of hepatocellular carcinoma with liver cirrhosis after subsegmentectomy of the liver is reported, with special reference to the occurrence of the hemodilution phenomenon in the postoperative period. The hematocrit value gradually decreased until the 4th postoperative day owing to hemodilution. While cardiac output increased following the hemodilution, the oxygen delivery did not increase because of the anemia. However, the oxygen consumption was maintained above the critical level. When the hematocrit value was 16%, the oxygen consumption decreased to the critical level and acidosis progressed. Therefore 400ml of blood was transfusd. Then the oxygen delivery, oxygen consumption, and the base excess returned to normal range.
This report suggests that while the optimal hematocrit value after hepatectomy is still unknown, at least we can safely observe the patient without blood transfusion until the hematocrit value falls below 20%, when hemodilution occurs in the postoperative period.
