Analysis Of Risk Factors For Hepatic Insufficiency After Major Hepatectomy In Patients With Hilar Cholangiocarcinoma

Objective:To analyze the risk factors for posthepatectomy hepatic insufficiency in patients with hilar cholangiocarcinoma.Methods:The clinical data of 83 patients with hilar cholangiocarcinoma who underwent major hepatectomy in the General Surgery of Shengjing Hospital affiliated to China Medical University from February 2012 to December 2018 were retrospectively analyzed.Preoperative and intraoperative risk factors associated with posthepatectomy hepatic insufficiency were univariately and multivariately analyzed.Results:The probability of posthepatectomy hepatic insufficiency in patients with hilar cholangiocarcinoma was 21.7%.In multivariate analysis,the surgical procedure for right extensive hepatectomy(OR=3.484;95% CI,0.651-9.842;P=0.017),preoperative cholangitis(OR=3.170;95% CI,1.090-9.221;P=0.022),total bilirubin>300umol/L(OR=2.975;95% CI,1.291-12.565;P= 0.044),intraoperative blood loss >800ml(OR=1.951;95% CI,0.832-8.654;P=0.048)are independent risk factors of posthepatectomy hepatic insufficiency.Conclusion:Right extensive hepatectomy,preoperative cholangitis,total bilirubin greater than 300umol/L and intraoperative blood loss greater than 800 ml are independent risk factors of posthepatectomy hepatic insufficiency in patients with hilar cholangiocarcinoma.