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Gastrectomy history as a predictor of post-hepatectomy complications

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Abstract

Purpose

The effect of a history of gastrectomy on patients undergoing hepatectomy is unclear. We investigated the relationship between postoperative complications of Clavien–Dindo grade III or higher and a history of gastrectomy in patients undergoing hepatectomy.

Methods

The subjects of this retrospective analysis were 474 consecutive patients who underwent hepatectomy at our institute for hepatic malignancy, classified into groups of those with or without a history of gastrectomy and those with or without postoperative complications. We compared the clinicopathological factors between the groups.

Results

There were no hospital deaths. Gastrectomy history was identified in 22 patients (4.6%) and was significantly associated with advanced age, low body mass index, male sex, decreased serum albumin level, decreased hemoglobin level, low PNI, low CONUT score, high incidence of postoperative complications, and longer hospital stay. Multivariate analyses revealed that the independent risk factors for postoperative complications were gastrectomy history, an albumin-bilirubin score of 2/3, primary liver cancer, high serum creatinine level, advanced age, and prolonged operation time.

Conclusions

Gastrectomy history was an independent predictor of postoperative complications in patients undergoing hepatectomy for hepatic malignancies. Patients with a history of gastrectomy were likely to suffer postoperative bile leakage and pneumonia.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin. 2011;61:69–90.

    Article  Google Scholar 

  2. Levi F, Lucchini F, Negri E, Boyle P, La Vecchia C. Changed trends of cacer mortality in the elderly. Ann Oncol. 2001;12:1467–2147.

    Article  CAS  Google Scholar 

  3. Araki K, Harimoto N, Shirabe K. Global standardization of laparoscopic liver resection and challenges for the future. Hepatobiliary Surg Nutr. 2019;8(4):386–8.

    Article  Google Scholar 

  4. Peng L, Cao J, Hu X, **ao W, Zhou Z, Mao S. Safety and feasibility of laparoscopic liver resection for patients with previous upper abdominal surgery: a systematic review and meta-analysis. Int J Surg. 2019;65:96–106.

    Article  Google Scholar 

  5. Kubota T, Shoda K, Konishi H, Okamoto K, Otsuji E. Nutrition update in gastric cancer surgery. Ann Gastroenterol Surg. 2020;4(4):360–8.

    Article  Google Scholar 

  6. Ke M, Xu T, Li N, Yifan Ren, Aihua Shi, et al. Prognostic nutritional index predicts short-term outcomes after liver resection for hepatocellular carcinoma within the Milan criteria. Oncotarget. 2016;7(49):81611–20.

    Article  Google Scholar 

  7. Schütte K, Schulz C, Malfertheiner P. Nutrition and hepatocellular cancer. Gastrointest Tumors. 2016;2(4):188–94.

    Article  Google Scholar 

  8. Harimoto N, Yoshizumi T, Inokuchi S, Itoh S, Adachi E, Ikeda Y, et al. Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma: a multi-institutional study. Ann Surg Oncol. 2018;25(11):3316–23.

    Article  Google Scholar 

  9. Harimoto N, Hoshino H, Muranushi R, Hagiwara K, Yamanaka T, Ishii N, et al. Skeletal muscle volume and intramuscular adipose tissue are prognostic predictors of postoperative complications after hepatic resection. Anticancer Res. 2018;38(8):4933–9.

    Article  Google Scholar 

  10. Dindo D, Demartines N, Clavien PA. Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg. 2004;240(2):205–13.

    Article  Google Scholar 

  11. Koch M, Garden OJ, Padbury R, Rahbari NN, Adam R, Capussotti L, et al. Bile leakage after hepatobiliary and pancreatic surgery: a definition and grading of severity by the international study group of liver surgery. Surgery. 2011;149(5):680–8.

    Article  Google Scholar 

  12. Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach-the ALBI grade. J Clin Oncol. 2015;33(6):550–8.

    Article  Google Scholar 

  13. Harimoto N, Muranushi R, Hoshino K, Yamanaka T, Hagiwara K, Ishii N, et al. Albumin-indocyanine green evaluation (ALICE) grade predicts bile leakage after hepatic resection. Surg Today. 2020;50(8):849–54.

    Article  CAS  Google Scholar 

  14. Chan AW, Chan SL, Wong GL, Wong VW, Chong CC, Lai PB, et al. Prognostic nutritional index (PNI) predicts tumor recurrence of very early/early stage hepatocellular carcinoma after surgical resection. Ann Surg Oncol. 2015;22(13):4138–48.

    Article  Google Scholar 

  15. de Ulibarri Perez JI, Gonzalez-Madrono A, de Villar NG, Gonzalez P, Gonzalez B, Mancha A, et al. CONUT: a tool for controlling nutritional status first validation in a hospital population. Nutr Hosp. 2005;20:38–45.

    Google Scholar 

  16. Harimoto N, Yoshizumi T, Sakata K, Nagatsu A, Motomura T, Itoh S, et al. Prognostic significance of preoperative controlling nutritional status (CONUT) score in patients undergoing hepatic resection for hepatocellular carcinoma. World J Surg. 2017;41(11):2805–12.

    Article  Google Scholar 

  17. Yamashita Y, Taketomi A, Itoh S, Kitagawa D, Kayashima H, Harimoto N, et al. Longterm favorable results of limited hepatic resections for patients with hepatocellular carcinoma: 20 years of experience. J Am Coll Surg. 2007;205(1):19–26.

    Article  Google Scholar 

  18. Rahbari NN, Koch M, Mehabi A, Weidmann K, Motschall E, Kahlert C, et al. Portal triad clam** versus vascular exclusion for vascular control during hepatic resection: a systematic review and meta-analysis. J Gastrointest Surg. 2009;13:558–68.

    Article  Google Scholar 

  19. Harimoto N, Shirabe K, Ikegami T, Yoshizumi T, Maeda T, Kajiyama K, et al. Postoperative complications are predictive of poor prognosis in hepatocellular carcinoma. J Surg Res. 2015;199(2):470–7.

    Article  Google Scholar 

  20. Andreatos N, Amini N, Gani F, Margonis GA, Sasaki K, Thompson VM, et al. Albumin-bilirubin score: predicting short-term outcomes including bile leak and post-hepatectomy liver failure following hepatic resection. J Gastrointest Surg. 2017;21(2):238–48.

    Article  Google Scholar 

  21. Tanaka K, Kumamoto T, Nojiri K, Takeda K, Endo I. The effectiveness and appropriate management of abdominal drains in patients undergoing elective liver resection: a retrospective analysis and prospective case series. Surg Today. 2013;43(4):372–80.

    Article  Google Scholar 

  22. Tanaka M. Advances in research and clinical practice in motor disorders of the sphincter of Oddi. J Hepatobiliary Pancreat Surg. 2002;9(5):564–8.

    Article  Google Scholar 

  23. Odani K, Nimura Y, Yasui A, Akita Y, Shionoya S. Paradoxical response to cerulein on sphincter of Oddi in the patient with gastrectomy. Dig Dis Sci. 1992;37(6):904–11.

    Article  CAS  Google Scholar 

  24. Strücker B, Stockmann M, Denecke T, Neuhaus P, Seehofer D. Intraoperative placement of external biliary drains for prevention and treatment of bile leaks after extended liver resection without bilioenteric anastomosis. World J Surg. 2013;37(11):2629–34.

    Article  Google Scholar 

  25. Nanashima A, Abo T, Shibuya A, Tominaga T, Matsumoto A, Tou K, et al. Does the placement of a cystic duct tube after a hepatic resection help reduce the incidence of post-operative bile leak? HPB (Oxford). 2013;15(7):517–22.

    Article  Google Scholar 

  26. Ishii T, Hatano E, Furuyama H, Manaka D, Terajima H, Uemoto S. Preventive measures for postoperative bile leakage after central hepatectomy: a multicenter, prospective, observational study of 101 patients. World J Surg. 2016;40(7):1720–8.

    Article  Google Scholar 

  27. Foster CA, Charles EJ, Turrentine FE, Sohn MW, Kron I, Jones RS. Development and validation of procedure-specific risk score for predicting postoperative pulmonary complication: a NSQIP analysis. J Am Coll Surg. 2019;229(4):355–65.

    Article  Google Scholar 

  28. Kimura R, Moriyama T, Ohuchida K, Shindo K, Nagai S, Ohtsuka T, et al. Risk factors for postoperative pneumonia after laparoscopic gastrectomy in patients aged 75 years and over with gastric cancer. Asian J Endosc Surg. 2020. https://doi.org/10.1111/ases.12883.

    Article  PubMed  Google Scholar 

  29. Liu J, Reid J, Trochsler M, Leopardi L, Edwards S, Maddern G. Impact of ageing on hepatic malignancy resection: is age really a risk factor for mortality? World J Surg. 2021;45(3):841–8.

    Article  Google Scholar 

  30. Harimoto N, Araki K, Ishii N, Muranushi R, Hoshino K, Hagiwara K. Predictors of postoperative ascites after hepatic resection in patients with hepatocellular carcinoma. Anticancer Res. 2020;40(8):4343–9.

    Article  CAS  Google Scholar 

  31. Takahara T, Wakabayashi G, Konno H, Gotoh M, Yamaue H, Yanaga K, et al. Comparison of laparoscopic major hepatectomy with propensity score matched open cases from the national clinical database in Japan. J Hepatobiliary Pancreat Sci. 2016;23(11):721–34.

    Article  Google Scholar 

  32. Takahara T, Wakabayashi G, Beppu T, Aihara A, Hasegawa K, Gotohda N, et al. Long-term and perioperative outcomes of laparoscopic versus open liver resection for hepatocellular carcinoma with propensity score matching: a multi-institutional Japanese study. J Hepatobiliary Pancreat Sci. 2015;22(10):721–7.

    Article  Google Scholar 

  33. Serenari M, Han KH, Ravaioli F, Kim SU, Cucchetti A, Han DH, et al. A nomogram based on liver stiffness predicts postoperative complications in patients with hepatocellular carcinoma. J Hepatol. 2020;73(4):855–62.

    Article  Google Scholar 

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Correspondence to Norifumi Harimoto.

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Norifumi Harimoto and the other co-authors have no conflicts of interest to declare.

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Harimoto, N., Araki, K., Hagiwara, K. et al. Gastrectomy history as a predictor of post-hepatectomy complications. Surg Today 52, 494–501 (2022). https://doi.org/10.1007/s00595-021-02366-7

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  • DOI: https://doi.org/10.1007/s00595-021-02366-7

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