Upper Gastro-intestinal Disorder after Left Hepatectomy

Abstract

We experienced 3 cases having upper gastrointestinal complaint for long time after left hepatectomy. We therefore hypothesized that left hepatectomy may be related to this complaint. We compared the incidence of the complaint between 10 left hepatectomized patients and 10 right hepatectomized patients operating at same period. This complaint occurred in 5 of 10 patients with left hepatectomy, but in only one patient with right hepatectomy. Upper gastrointestinal barium study revealed that displacement of the stomach was carried out to the upper part in 2 patients who had severe dyspepsia. We therefore compared the position of the pylorus using computed tomography between 5 symptomatic patients and 5 non-symptomatic patients having left hepatectomy. The vertical distance between the pylorus and the gastric fundus in symptomatic patients was significantly smaller than that in non-symptomatic patients. Since the deformity of the stomach may be due to the large dead space after left hepatectomy, we performed the fixation of the greater omentum to the abdominal wall to keep the gastric position after left hepatectomy in 5 patients. As a result, no patients complained upper gastrointestinal symptoms. We think the fixation of greater omentum to the abdominal wall after left hepatectomy is useful to maintain the good postoperative course.