Table of Contents
HPB Surgery
Volume 1, Issue 2, Pages 141-147
http://dx.doi.org/10.1155/1989/31824

Patterns of Improvement in Resection of Hepatocellular Carcinoma in Cirrhotic Patients: Results of a Non Drainage Policy

1Groupe de Recherche sur la Chirurgie du Foie et de l'Hypertension Portale, Hôpital Paul Brousse, Villejuif, France
2Hôpital Bicêtre, Le Kremlin Bicêtre, France
3Hôpital Louise Michel, Evry, France
4Hôpital Paul Brousse, Villejuif cédex, 94804, France

Received 18 July 1988; Accepted 9 September 1988

Copyright © 1989 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A prolonged ascitic leak through abdominal drains is a source of postoperative complications and of prolonged postoperative hospital stay after liver resection for hepatocellular carcinoma (HCC) in cirrhotic patients. Therefore we elected to abstain from routine abdominal drainage in the last 14 resections in cirrhotic livers. A significantly smaller number of patients had postoperative complications following liver resections without drainage (7%) than historical controls with abdominal drainage (59%, p < 0.01). The number of complications related to ascites was significantly greater in patients with abdominal drainage (76%) than without (0%, p < 0.001). Postoperative hospital stay was also significantly longer following resections with abdominal drainage (19 ± 4 days) than in patients without (12 ± 1 days, p < 0.01). The long postoperative hospital stay in patients with abdominal drainage was related to ascitic discharge for a mean period of 13 ± 10 days. No clinically significant accumulation of ascites was noted in patients without drainage. A more frequent utilization of hepatic vascular inflow occlusion did not account for the better results in the group of patients without drainage. These results suggest that routine abdominal drainage should not be used following liver resection for HCC in cirrhotic patients. This appears to be another of the technical details improving postoperative results in these patients.