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Background. Disseminated intravascular coagulation (DIC) after hepatectomy is not well understood.
The objective of this retrospective study was to evaluate hemostatic changes after
extensive liver resection and to elucidate the frequency of posthepatectomy DIC.
Methods. In 100 patients without cirrhosis who underwent resection of two or more segments
of the liver for biliary tract carcinoma, various hemostatic parameters were measured
before and after resection, and the liver function of each patient was assessed.
Results. In patients with posthepatectomy liver failure, platelet count, fibrinogen concentrations,
and prothrombin time were significantly lower than in those without such failure.
Serum levels of fibrin degradation product did not differ significantly between the
two groups. The minimum platelet count was significantly negatively correlated with
serum total bilirubin level. Posthepatectomy DIC occurred in 2.0% of the patients.
Conclusions. After extensive liver resection patients exhibited a decreased platelet count with
hepatic dysfunction. However, this condition rarely resulted in DIC, at least in patients
without cirrhosis and serious postoperative complications.
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References
- Major hepatic resection: diagnostic techniques and metabolic problems.Surgery. 1963; 54: 56-66
- Studies on blood clotting factors in man after massive liver resection.Acta Chir Scand. 1967; 133: 189-195
- Hypercoagulability: thrombelastographic monitoring during extensive hepatic surgery.Arch Surg. 1974; 108: 605-608
- Increased fibrin/fibrinogen degradation products without increase of plasmin-α2-plasmin inhibitor complex after hepatectomy for hepatocellular carcinoma.Thromb Res. 1990; 57: 289-300
- Hemostatic problems in liver surgery.Scand J Gastroenterol. 1973; 8: 71-81
- Disseminated intravascular coagulation after hepatic resection.Surgery. 1990; 107: 172-176
- Disseminated intravascular coagulation (DIC): an approach.Am J Med. 1972; 52: 679-689
- Percutaneous transhepatic biliary drainage in patients with malignant biliary obstruction of the hepatic confluence.Hepatogastroenterology. 1992; 39: 296-300
- Hepatic segmentectomy with caudate lobe resection for bile duct carcinoma of the hepatic hilus.World J Surg. 1990; 14: 535-544
- Combined portal vein and liver resection for carcinoma of the biliary tract.Br J Surg. 1991; 78: 727-731
- Hepatopancreatoduodenectomy for advanced carcinoma of the biliary tract.Hepatogastroenterology. 1991; 38: 170-175
- Multiple organ failure associated with postoperative non-obstructive jaundice.Jap J Gastroenterol Surg. 1987; 20: 2455-2459
- Hemostatic abnormalities in liver disease.in: Colman RW Hirsh J Marder VJ Hemostasis and thrombosis: basic principles and clinical practice. 2nd ed. JB Lippincott Co, Philadelphia1987: 861-872
- Coagulation studies in patients with acute infectious hepatitis.Br J Haematol. 1972; 22: 761-771
- Significance of plasma fibrinopeptide A and high molecular weight fibrinogen in patients with liver cirrhosis.Br J Haematol. 1982; 52: 503-509
- Serum crosslinked fibrin (XDP) and fibrinogen/fibrin degradation products (FDP) in disorders associated with activation of the coagulation or fibrinolytic systems.Br J Haematol. 1985; 60: 715-722
- Elevation of factor VIII in acute fatal liver necrosis.Thromb Diath Haemorrh. 1970; 24: 161-174
- Plasma clotting factors in chronic hepatocellular disease.N Engl J Med. 1960; 263: 278-282
- The value of factor VIII levels in acquired hypofibrinogenemia.Am J Clin Pathol. 1973; 60: 897-902
Article info
Publication history
Accepted:
November 10,
1994
Footnotes
*Supported in part by a grant-in-aid for general scientific research (04404050) from the Ministry of Education, Science and Culture, Japan, and grants from the Uehara Memorial Foundation.
Identification
Copyright
© 1995 Mosby-Year Book, Inc. Published by Elsevier Inc.
