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DOI: 10.1055/s-0030-1263547
Postoperative course and clinical significance of biochemical blood tests following hepatic resection
Aims: Hepatic resection continues to be associated with substantial morbidity. Although biochemical blood tests are important for diagnosis of complications, there is limited data on their regular postoperative kinetics as well as on their course in patients with surgery-related morbidity.
Methods: A total of 835 consecutive patients underwent hepatic resection between January 2002 and January 2008. Biochemical blood tests were assessed preoperatively and on postoperative day (POD) one, three, five and seven. Analyses were stratified for the extent of resection (≤3 segments vs. >3 segments).
Results: A total of 451 (54%) patients underwent resection of ≤3 anatomic segments, whereas a resection of >3 segments was performed in 384 (48%) patients. Surgery-related morbidity was documented in 258 (31%) patients and occurred more frequently in patients with a major resection (p=0,001). The postoperative kinetics of serum bilirubin and INR as measures of hepatic function differed significantly depending on the extent of resection. Furthermore, they were significantly altered in patients with complications irrespective of the extent of resection. The extent of resection had, however, little impact on renal function and systemic haemoglobin levels. Surgery-related morbidity caused an increase in CRP levels only in patients with minor resections.
Conclusion: The present study provides a comprehensive analysis of the postoperative course of biochemical blood tests after hepatic resection. These data may help to recognise early patients with surgery-related complications during the postoperative course. The data may serve as the basis for the definition of complications after hepatic resection.