The Clinical Research And Prevention And Treatment On Cause Of Pleural Fluid After Hepatectomy

Objective: To approach the sources of pleural fluid after hepatectomy.Methods: 133 cases with primary hepatic carcinoma(PHC) undergoing hepatectomy were selected for retrospective study in hepatobiliary surgery department of affiliated Tumor hospital, GuangXi Medical University from 2003 to 2007.69 patients emerged pleural fluid (group G1) and 64 patients had no pleural fluid (group G2). Reviewing the below index, such as: hepatic function before or after operation, diameters of tumor, obstructive time of portal vein, section of operation, volume of bleeding during operation and volume of ascites, We approach the causes of pleural fluid after hepatectomy and effective strategies for prevention and treatment during operation.Results: pleural fluid emerged in 69 cases after hepatectomy. The ratio of cases undergoing right hepatectomy, especially with dissection of ligamentum triangulare dextrum and coronary ligament in group G1 was significant higher than group G2, volume of ascites after operation was more than G2 group. Hepatic function after surgery was much better in group G2 than in group G1. Ratio of cases with absolute alcohol injected to incisal edge and complicated with liver cirrhosis was higher than control group. There was no difference in statistics in hepatic function before operation, volume of bleeding, obstructive time of portal vein and diameter of tumor between two groups.Conclusions: pleural fluid complicating by hepatectomy is mainly related to operative site, hepatic function after operation, liver cirrhosis and injection of absolute alcohol to incisal edge. The main cause of pleural fluid after operation is dissection of right hepatic ligaments and damage to diaphragm during operation. So maintenance of fine hepatic function during operation, careful dissection of peri-hepatic ligaments and less damage to diaphragm may facilitate to reduce occurrance of plural fluid. The primary way to cure pleural fluid are protecting hepatic function,anti-inflammation and local suction, especially injection of certain drugs to pectoral cavity.