Özet:
Background. Intraoperative blood loss and red blood cell transfusion requirements have
a negative impact on outcome after orthotopic liver transplantation. In this study we
compared blood transfusion requirements, bile duct injury, and dissection of hepatic artery
rates in the patients with or without partial cholecystectomy during recipient hepatectomy.
Methods. From December 2008 to August 2011, 100 recipient hepatectomies were
performed by the same surgeon. Patients were divided into 2 groups. The first group
included patients with partial cholecystectomy, and the other group patients without partial
cholecystectomy. Each group consisted of 50 patients.
Results. In recipient hepatectomy group without partial cholecystectomy, intraoperative
blood transfusions were in the range of 3e11 units (mean, 6.3 units). In this group there
were 4 hepatic artery dissections and 2 bile duct injuries. In the group with partial cholecystectomy,
intraoperative blood transfusions were in the range of 0e7 units (mean,
3.1 units). In this group there was 1 hepatic artery dissection. There were no operative
mortalities in either group.
Conclusions. We recommend partial cholecystectomy during recipient hepatectomy of
cirrhotic patients, particularly with hydropic gallbladders, because bleeding from the points
of adherent gallbladder during mobilization of the liver is diminished and fewer artery
dissections and bile duct injuries develop, because the procedure facilitates dissection of
the hilar structures.
