SciELO - Scientific Electronic Library Online

 
vol.69 número1Metástasis cutáneas de cáncer de mama: revisión de la literaturaDiagnóstico, tratamiento y seguimiento de la hidatidosis índice de autoresíndice de materiabúsqueda de artículos
Home Pagelista alfabética de revistas  

Servicios Personalizados

Revista

Articulo

Indicadores

Links relacionados

  • En proceso de indezaciónCitado por Google
  • No hay articulos similaresSimilares en SciELO
  • En proceso de indezaciónSimilares en Google

Compartir


Revista chilena de cirugía

versión On-line ISSN 0718-4026

Resumen

CONCHA P, Mario  y  JARUFE C, Nicolás. Liver surgery: Considerations beyond the surgical technique. Rev Chil Cir [online]. 2017, vol.69, n.1, pp.89-93. ISSN 0718-4026.  http://dx.doi.org/10.1016/j.rchic.2016.06.013.

The mortality of liver resection surgery is 1-2%. Improve this will require optimizing details involving all caregivers of these patients. The first of these points is the evaluation of postoperative liver function. Various methods have been used to estimate it, without conclusive results regarding what is the most appropriate. Several studies evaluating the amount of residual parenchyma and its relationship to the development of postoperative liver failure recommend that in the presence of a healthy liver should be 20-25% of liver volume, 30-60% in cases of conditions that impair the functionality and 40-70% in cases of cirrhosis. The contribution of fluids administration and its relationship with morbidity, bleeding and development of renal failure have been studied. The volume restriction, maintenance of low central venous pressures appear as recommended strategies but must not compromise systemic perfusion that can determine organ dysfunction. Unlike what was observed in critically ill patients, the use of starches appears as a safe alternative in healthy patients and those undergoing liver transplantation. Alterations in coagulation tests should be evaluated, ideally through methods that allow to identify the cause. The thromboelastography appears as a suitable alternative. Prophylactic administration of blood components is not indicated and can be a source of morbidity. Analgesia should be optimized, being epidural analgesia a good alternative in the presence of healthy liver and procedures involving no more than a lobectomy.

Palabras clave : Hepatic surgery; Mortality; Preoperative evaluation; Coagulation.

        · resumen en Español     · texto en Español     · Español ( pdf )

 

Creative Commons License Todo el contenido de esta revista, excepto dónde está identificado, está bajo una Licencia Creative Commons