Influencing Factors Of Complications After Liver Resection For Hepatocellular Carcinoma

Objective:To analyze the relationship between the complications after resection in patients with hepatocellular carcinoma (HCC) and their clinical, operative and pathologic data, and to study the risk factors in the patients with the complications.Methods:Clinical and pathological data of 467 HCC patients from Jan.2002 to Dec. 2008 ware collected; and the risk factors in the patients with the complication was analyzed by univariate and multivariate analysis.Results:The morbidity was 15.2%(71/467), the mortality was 1.3%(6/467) within 30 days after hepatectomy. These complications included pleural effusion (25 cases), liver dysfunction and liver failure (18 cases), incision problems (9 cases). Apart from the complications in 11 cases that were not related to hepatectomy,456 cases was studied retrospectively. We found that in the patients with complication, preoperative serum platelet level<100×109/L (P=0.001), Child-Pugh classification B (P=0.015), vascular cancer thrombus (P=0.006), multiple tumor (P=0.035), and blood transfusion (P=0.030) was more than in patients without complication. By Logistic analysis, Child-Pugh classification, vascular cancer thrombus, blood transfusion was independent risk factors for complations (P<0.05). Correlation analysis revealed that patients occurring complications after hepatectomy were significantly related to patients with preoperative platelet<100×109/L, Child-Pugh classification B, vascular tumor thrombus and blood transfusion.Conclusion:The common complications of hepatectomy were the pleural effusion, liver dysfunction and liver failure, and incision problem. Child-Pugh classification B, vascular cancer thrombus and blood transfusion was independent risk factors for patients with complication. It is important that accurate evaluation of liver function, strict surgical indications, careful operation and less bleeding for reducing the occurrence of complication.