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Review
. 2025 Jan 20:37:e1856.
doi: 10.1590/0102-6720202400062e1856. eCollection 2025.

COMPLICATIONS AFTER HEPATECTOMY

Claudemiro Quireze Junior  1 , Fabricio Ferreira Coelho  2 , Agnaldo Soares Lima  3 , Hugo Pinto Marques  4 , Martin Palavecino  5 , Timothy Pawlik  6 , Rene Adam  7 , Olivier Soubrane  8 , Paulo Herman  2 , Ricardo Lemos Cotta-Pereira  9
Affiliations
Review

COMPLICATIONS AFTER HEPATECTOMY

Claudemiro Quireze Junior et al. Arq Bras Cir Dig. .

Abstract
in English, Portuguese

Complete removal of metastatic disease and maintenance of an adequate liver remnant remains the only treatment option with curative intent concerning colorectal liver metastases. Surgery impacts on the long-term prognosis and complications adversely affect oncological results. The actual morbidity involving this scenario is debatable and estimated to be ranging from 15% to 50%. Postoperative complications eventually lead to an increase in both mortality rates and tumor recurrence. Biliary fistula and liver failure are the leading complications following liver resection to metastatic colorectal cancer. Prophylactic drainage does not prevent fistulas or hemorrhage. Drainage along with endoscopic intervention and/or surgery may be necessary for grade B and C fistulas. Liver failure is a potentially lethal complication with few therapeutic options. Patient selection and preoperative care are crucial for its prevention.

A remoção completa da doença metastática e a manutenção de um remanescente hepático adequado continuam sendo o único tratamento com intenção curativa em relação às metástases hepáticas colorretais. A cirurgia impacta no prognóstico de longo prazo e as complicações afetam adversamente os resultados oncológicos. A morbidade real envolvendo esse cenário é discutível e estimada variando de 15 a 50%. Complicações pós-operatórias eventualmente levam a um aumento nas taxas de mortalidade e recorrência do tumor. Fístula biliar e insuficiência hepática são as principais complicações após a ressecção hepática para câncer colorretal metastático. A drenagem profilática não previne fístulas ou hemorragia. A drenagem junto com intervenção endoscópica e/ou cirurgia pode ser necessária para fístulas de graus B e C. A insuficiência hepática é uma complicação potencialmente letal com poucas opções terapêuticas. A seleção do paciente e os cuidados pré-operatórios são cruciais para sua prevenção.

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Conflict of interest statement

Conflict of interests: None

References

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