Risk Factors Analysis Of Early Complications After Hepatectomy For HCC

Objective:This study aimed to identify the risk factors for postoperative early complications in patients undergoing liver resection for hepatocellular carcinoma,and to identify the high-risk patients who may suffer from complications during perioperative period so as to help clinical decision-making.Methods:The clinical data of 119 consecutive patients who underwent liver resection for HCC between June 2012 to November 2019 in the First Affiliated Hospital of Kunming Medical University were analyzed retrospectively.All of these patients were divided into two groups,positive group and negative group,according to whether complications occurred within 30 days after operation.Variables that may induce the occurrence of early complications after hepatectomy were collected and were analysised by using different kinds of statistical test methods for single factor analysis.The difference was considered as statistically significant when the P value less than 0.05.Variables statistically significant in univariate analysis were included in binary logistic regression analysis,and were considered as risk factors for early complications after hepatectomy when P?0.05Results:Among 119 patients who underwent hepatectomy for HCC in this study,45 patients developed early complications,the incidence of complications was 37.8%.The incidence of complications was displaied from high to low as follows:infectious complications 35.3%(42/119),liver failure 10.9%(13/119),ascites 10.9%(13/119),bleeding 3.4%(4/119),bile leakage 2.5%(3/119).Five patients died of post-hepatectomy liver failure and multiple organ failure on the 5th,8th,12th,16th and 20th day after operation respectively,with a mortality rate of 4.2%(5/119).Single factor analysis showed that seven variables were statistically significant.They were MELD(P=0.049),the extent of liver resected(P=0.003),operation duration(P?0.001),intraoperative hemorrhage(P=0.007),intraoperative infusion(P?0.001),perioperative blood transfusion(P?0.001)and abdominal invasion(P=0.002).The results of binary logistic regression analysis showed that MELD(P=0.006,OR=1.685),the extent of liver resected(P=0.027,OR=3.275),intraoperative infusion volume(P=0.048,OR=1.001)and perioperative blood transfusion(P=0.038,OR=3.252)were risk factors for early complications after hepatectomy for HCC.Conclusions:1.The incidence of early complications after liver resection for HCC was high(37.8%,45/119),the infectious complications were the most common one among all of the early complications,and the pulmonary infection accounted for the majority of infectious complications,with an incidence up to 31.1%(37/1 19).2.The incidence of post-hepatectomy liver failure(PHLF)was relatively low(10.9%,13/119),but the mortality was high(38.5%,5/13).More attention should be paid to the patients with high risk of liver failure during perioperative period.3.Binary logistic regression analysis showed that the score of model for end-stage liver disease,the extent of hepatectomy,the amount of intraoperative infusion and perioperative blood transfusion were risk factors of early complications after hepatectomy for HCC.