Partial Cholecystectomy: A Technique That Makes Hilar Dissection Easier in Recipient Hepatectomy

Abstract Background Intraoperative blood loss and red blood cell transfusion requirements have a negative impact on outcome after orthotopic liver transplantation. In this study we compared blood transfusion requirements, bile duct injury, and dissection of hepatic artery rates in the patients with...

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Bibliographic Details
Published in:Transplantation proceedings 2014, Vol.46 (1), p.216-218
Main Authors: Ara, C, Özdemir, F, Ateş, M, Özgör, D, Kutlutürk, K
Format: Article
Language:English
Subjects:
Adult
Aged
Bile Ducts - injuries
Bile Ducts - surgery
Blood Transfusion - methods
Cholecystectomy - methods
Female
Gallbladder - surgery
Hepatectomy - methods
Hepatic Artery - surgery
Humans
Liver Failure - surgery
Liver Transplantation - adverse effects
Living Donors
Male
Middle Aged
Surgery
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Summary:Abstract Background Intraoperative blood loss and red blood cell transfusion requirements have a negative impact on outcome after orthotopic liver transplantation. In this study we compared blood transfusion requirements, bile duct injury, and dissection of hepatic artery rates in the patients with or without partial cholecystectomy during recipient hepatectomy. Methods From December 2008 to August 2011, 100 recipient hepatectomies were performed by the same surgeon. Patients were divided into 2 groups. The first group included patients with partial cholecystectomy, and the other group patients without partial cholecystectomy. Each group consisted of 50 patients. Results In recipient hepatectomy group without partial cholecystectomy, intraoperative blood transfusions were in the range of 3–11 units (mean, 6.3 units). In this group there were 4 hepatic artery dissections and 2 bile duct injuries. In the group with partial cholecystectomy, intraoperative blood transfusions were in the range of 0–7 units (mean, 3.1 units). In this group there was 1 hepatic artery dissection. There were no operative mortalities in either group. Conclusions We recommend partial cholecystectomy during recipient hepatectomy of cirrhotic patients, particularly with hydropic gallbladders, because bleeding from the points of adherent gallbladder during mobilization of the liver is diminished and fewer artery dissections and bile duct injuries develop, because the procedure facilitates dissection of the hilar structures.
ISSN:0041-1345
1873-2623
DOI:10.1016/j.transproceed.2013.05.016