Posthepatectomy Liver Failure is More Complex than We Thought

Xian-Zhang Luo, Jian-Ting Zeng, Jie-Feng Zhang, Yu Wang, Ai Shen, Yi Zhang, Yan-Lin Zhang, He-Jun Deng and Nian-Qiao Gong

Key Laboratory for Biorheological Science and Technology of Ministry of Education, Chongqing University, Chongqing University Cancer Hospital, China
Institute of Organ Transplantation, Key Laboratory of the Ministry of Health and the Ministry of Education, Tongji Hospital, China
Chongqing Key Laboratory of Translational Research for Cancer Metastasis and Individualized Treatment, Chongqing University Cancer Hospital, China
Both authors contributed equally to this work

^*Correspondance to: Nian-Qiao Gong 

 PDF  Full Text DOI: 10.25107/2474-1647.2222

Abstract

Introduction: PHLF is the most serious complication after hepatectomy. And the reason for PHLF was complex. We report two cases of PHLF companied with elevated PCT and low-density area examined by CT.Case
Presentation: A 44 year old male experienced left lobe hepatectomy due to carcinoma rupture and a 48 year old male underwent hepatic pancreas to duodenectomy because of duodenal neuroendocrine tumor with liver metastasis. Both patients had elevated INR and bilirubin on POD 5 and POD12, respectively. We eliminated the common reason for PHLF and excluded the reason of PCT elevation besides infection. Therefore, infection was deemed to the reason caused PHLF in our cases. Then, antibiotics were given, the patient recovered gradually both in liver function and CT imagine. This observation highlights the complex of the disease and the value of PCT and CT in the patient who underwent Posthepatectomy.Conclusion: We recommended PCT as a routine monitoring marker in the patient undergo hepatic resection. And CT was mandatory when PCT elevated coupled with liver function deteriorated.

Keywords

Posthepatectomy liver failure; Procalcitonin; Computed tomography

Cite the article

Luo X-Z, Zeng J-T, Zhang J-F, Wang Y, Shen A, Zhang Y, et al. Posthepatectomy Liver Failure is More Complex than We Thought. Clin Surg. 2018; 3: 2222.