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. 2017 Aug;21(3):114-121.
doi: 10.14701/ahbps.2017.21.3.114. Epub 2017 Aug 31.

Diaphragmatic hernia following liver resection: case series and review of the literature

Francesco Esposito  1 , Chetana Lim  1 , Chady Salloum  1 , Michael Osseis  1 , Eylon Lahat  1 , Philippe Compagnon  1   2 , Daniel Azoulay  1   2
Affiliations

Diaphragmatic hernia following liver resection: case series and review of the literature

Francesco Esposito et al. Ann Hepatobiliary Pancreat Surg. 2017 Aug.

Abstract

Backgrounds/aims: Postoperative diaphragmatic hernia, following liver resection, is a rare complication.

Methods: Data of patients who underwent major hepatectomy for liver tumors, between 2011 and 2015 were retrospectively reviewed. The literature was searched for studies reporting the occurrence of diaphragmatic hernia following liver resection.

Results: Diaphragmatic hernia developed in 2.3% of patients (3/131) with a median delay of 14 months (4-31 months). One patient underwent emergency laparotomy for bowel obstruction and two patients underwent elective diaphragmatic hernia repair. At last follow-up, no recurrences were observed. Fourteen studies including 28 patients were identified in the literature search (donor hepatectomy, n=11: hepatectomy for liver tumors, n=17). Diaphragmatic hernia was repaired emergently in 42.9% of cases and digestive resection was necessary in 28.5% of the cases. One patient died 3 months after hepatectomy, secondary to sepsis, from a segment of small bowel that perforated into the diaphragmatic hernia.

Conclusions: Although rare, diaphragmatic hernia should be considered as an important complication, especially in living donor liver transplant patients. Diaphragmatic hernia should be repaired surgically, even for asymptomatic patients.

Keywords: Diaphragmatic hernia; Liver resection; Repair; Systematic review.

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Figures

Fig. 1
Fig. 1. Preoperative computed tomography showing the diaphragmatic hernia.
Fig. 2
Fig. 2. Intraoperative view of the diaphragmatic hernia. (A) A white arrow shows the right colon flexure incarcerated in the hernia. (B) A white star shows the site of the hernia. (C) Primary closure of the hernia.
Fig. 3
Fig. 3. Flow diagram showing the selection of studies reporting diaphragmatic hernia, following liver resection for systematic review.
See this image and copyright information in PMC

References

    1. Lee MK, 4th, Gao F, Strasberg SM. Perceived complexity of various liver resections: results of a survey of experts with development of a complexity score and classification. J Am Coll Surg. 2015;220:64–69. - PMC - PubMed
    1. Zimmitti G, Roses RE, Andreou A, Shindoh J, Curley SA, Aloia TA, et al. Greater complexity of liver surgery is not associated with an increased incidence of liver-related complications except for bile leak: an experience with 2,628 consecutive resections. J Gastrointest Surg. 2013;17:57–64. discussion p.64-65. - PMC - PubMed
    1. Rubikas R. Diaphragmatic injuries. Eur J Cardiothorac Surg. 2001;20:53–57. - PubMed
    1. Tabrizian P, Jibara G, Shrager B, Elsabbagh AM, Roayaie S, Schwartz ME. Diaphragmatic hernia after hepatic resection: case series at a single Western institution. J Gastrointest Surg. 2012;16:1910–1914. - PubMed
    1. Willemse P, Schütte PR, Plaisier PW. Thoracoscopic repair of a Bochdalek hernia in an adult. Surg Endosc. 2003;17:162. - PubMed

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