The Transplantation Unit of Leeds Hospita, England published a very interesting article in November’s issue of BJS, regarding the importance of steatosis and liver surgery.
They reviewed patients undergoing resection for CRLM from January 2000 to September 2005 identified from a hepatobiliary database. Data analysed included laboratory measurements, extent of hepatic resection, blood transfusion requirements and steatosis.
There were 386 patients with a median age of 66 (range 32–87) years, of whom 201 had at least one co-morbid condition and 194 had an American Society of Anesthesiologists grade of I. Anatomical resection was performed in 279 patients and non-anatomical resection in 107; 165 had additional procedures. Steatosis in 194 patients was classified as mild in 122, moderate in 60 and severe in 12. The overall morbidity rate was 36 per cent (139 patients) and the mortality rate was 1·8 per cent (seven patients). Admission to the intensive care unit, morbidity, infective complications and biochemical profile changes were associated with greater severity of steatosis. Independent predictors of morbidity were steatosis, extent of hepatic resection and blood transfusion.
The Department of Gastroenterology at the Amsterdam Medical Center published in November’s issue of Gut a very insightful article regarding bile duct injuries.
The University of Toronto, Canada, published in this month’s issue of the Journal of the American College of Surgeons a very interesting paper.