The Analysis Of Postoperative Complications' Relative Factors During Radical Resection Of The Liver With HAE Using Clavien-Dindo Classification

Objective:This study retrospectively analyzed the cases of hepatic alveolar echinococcosis in patients undergoing radical hepatectomy,and explored the grading system of the Clavien-Dindo in HAE,and classified complications of hepatic alveolar echinococcosis after radical hepatectomy with it.The applicability of hepatic alveolar echinococcosis(HAE)in radical hepatectomy is to analyze the differences between general conditions,preoperative conditions,intraoperative conditions,postoperative conditions and complications,and it's important to explore influencing factors.Methods:Retrospective analysis of medical records of patients with hepatic alveolar echinococcosis who underwent radical hepatectomy from January 2016 to October2018.Patients with grade II or higher complications were defined as postoperative severe complications group,and patients with grade II complications were defined as postoperative non-serious complications group,and the related factors of early postoperative complications were discussed.Collect medical records of the two groups of patients,including the general situation,preoperative data,intraoperative data,and postoperative conditions.The data were analyzed by?~2 test,or t test.The serious complications of postoperative complications were used as the dependent variable,and the statistically significant factors were used as independent variables.Further multivariate logistic regression analysis was performed to detect the independent influence factors.Results:(1)Univariate analysis results:gender,age,preoperative creatinine,preoperative total bilirubin,Child-Pugh grading about preoperative liver function,preoperative AST,postoperative AST,postoperative LDH,postoperative PLT,postoperative mononuclear cell count,postoperative albumin,P>0.05,and the difference was not statistically significant;however,indocyanine green test 15 min retention rate(ICG-R15),preoperative INR,preoperative ASA grade,intraoperative blood loss,intraoperative red load,first hepatic occlusion time,liver resection range,extrahepatic surgery,postoperative total bilirubin,P<0.05,and the difference was statistically significant.(2)Multivariate logistic regression analysis showed that preoperative INR,intraoperative blood loss,intraoperative red suspension,first hepatic occlusion time,extrahepatic surgery,and postoperative total bilirubin,P>0.05,and the difference was not statistically significant;the indocyanine green test 15 min retention rate(ICG-R15),preoperative ASA grade,liver resection range,P<0.05 and?>0,which shows the difference was statistically significant and they were risk factors.Conclusion:The Clavien-Dindo grading system is used in radical hepatectomy for hepatic alveolar echinococcosis,which can be used to quantify the early postoperative complications.They were independent risk factors for serious complications in the early postoperative period,including the 15 min retention rate of the indocyanine green test(ICG-R15),the third preoperative ASA grade,and the liver resection range?3hepatic segments.