Analysis of intra-operative hemorrhage during resection of benign lesions of liver

Objective To explore the technique of controlling intra-operative hemorrhage during resection of benign lesion of liver.Methods Data of 955 consecutive cases of benign hepatic lesion undergoing resection,admitted to the Air force General Hospital of PLA and General Hospital of PLA from Jan.1986 to Dec.2010,were reviewed retrospectively.The intra-operative hemorrhage and amount of transfusion,perioperative state and postoperative complications were analyzed.Results Among 955 cases,hemangioma and hepatolithiasis were two most numerous lesions,accounting for 44.3%(423 cases) and 27.7%(265 cases),respectively.Among 872 cases evaluated with Child-Pugh score,847(97.1%) were Child-A.596(62.4%) patients intra-operative hemorrhage was less than 200ml,in 122(12.8%) it was of 200-400ml,in 164(17.2%) it was 400-1000ml,whereas in 73 cases(7.6%) it was 1000ml.359 patients(37.6%) received blood transfusion,and 81 patients(8.5%) received auto-blood transfusion.The operation time was 240.6±98.3 minutes,and the length of stay(LOS) after operation was 14.0±8.2 days.The incidence of postoperative complication was 13.7%,and perioperative mortality was 0.2%.With multivariate Logistic regression analysis,the operating time(P=0.003,OR=1.013) and the value of serum albumin(ALB)(P=0.035,OR=0.838) were independent predictors of morbidity.The prolongation of operating time was the risk factor,and the increase of ALB was the protective factor.A decreasing tendency in operating time,blood transfusion rate,incidence of complication and LOS after operation in the last 24 years(P < 0.01).Conclusion Resection of benign lesions of the liver is a safe and efficient procedure.Meanwhile,optimal perioperative preparation and innovation in surgical technique may effectively control intra-operative hemorrhage during resection.