Evaluation of the intraoperative blood loss after major hepatic resections

D.Corneci¹, S.Marinescu¹, Mădălina Duţu¹, A.Ciocănea¹ , A.Tudose¹, S.Negoiţă¹, Cristina Corneci¹, F.Purcaru²
1) Spitalul Clinic de Urgenţă Militar Central „Carol Davila” Bucureşti
2) Spitalul Clinic Judeţean Craiova

Abstract

Major hepatic resections have an important hemorrhagic risk. The blood loss estimation is useful because it allows the diagnosis and the proper treatment of acute post hemoragic anemia and avoids excessive transfusion.

The purpose of the study is the indirect estimation of intraoperative blood loss and the analysis of its variation depending on the perioperative parameters.

Material and Method. The study comprised 117 patients with hepatic tumors admitted between 1994-2005 to the Surgery 1 Department of the Military Central Clinical Hospital. The retroactive calculation of blood losses was possible for 94 patients. The indirect estimation relied upon the difference between prioperative and postoperative circulating red blood cell mass. We analysed the variation of blood loss and its pattern depending on perioperative parameters.

Results. The amount of blood loss varied from 200 ml to 5360 ml, with an average of 1020.9 ± 694.9 ml. Maximum loss was found during the median hepatectomy (1905 ± 982.9 ml),followed by extended right hepatectomy (1580 ± 536.9 ml), hepatectomy on cirrhotic liver (1502.5 ± 713 ml) and atypical left hepatectomy (1480 ± 596.1 ml). Data has shown a very significant influence (p=0.002) of the amplitude of intervention: major resections (1240 ± 728.5 ml) versus minor resections (730.8 ± 529.7 ml).

Conclusions. The values of blood loss found were close to those cited in the literature. The most significant parameters which influenced the intraoperative hemorrhage, were the amplitude of resections and, for the minor resections, the malignancy of the tumor or the association of other surgical procedures.

Key words: hepatectomy, perioperative blood loss, acute posthaemorrhagic anemia

Estimarea pierderilor sanguine intraoperatorii în chirurgia hepatică majoră

Jurnalul Român de Anestezie Terapie intensivă 2006 Vol.13 Nr.2, 69-75