Background: Postoperative operative pulmonary complications (PPCs) after hepatic surgery are associated with\nincreased length of hospital stays. Intraoperative blood transfusion, extensive resection and different comorbidities\nhave been identified. Other parameters, like time of hepatic ischemia, have neither been clinically studied, though\nexperimental studies show that hepatic ischemia can provide lung injury. The objective of this study was to\ndeterminate the risk factors of postoperative pulmonary complications (PPCs) after hepatic resection within 7\npostoperative days.\nMethod: Ninety-four patients consecutively who underwent elective hepatectomy between January and December\n2013. Demographic data, pathological variables, and preoperative, intraoperative, and postoperative variables had been\nprospectively collected in a data base. The dependant variables studied were the occurrence of PPCs, defined before\nanalysis of the data.\nResults: PPCs occurred in 32 (34%) patients. A multivariate analysis allowed identifying the risk factors for PPCs. On\nmultivariate analysis, preoperative gamma-glutamyltransferase (GGT) elevation OR =5,12 [1,85-15,69] p = 0,002, liver\nischemia duration OR = 1,03 [1,01-1,06] p = 0,01 and the intraoperative use of vasopressor OR = 4,40 [1,58-13,36]\np = 0,006 were independently associated with PPCs. For every 10 min added in ischemia duration, the OR of\nthe risk of PPCs was estimated to be 1.37 (CI95% = [1.08-1.81], p = 0.01).\nConclusion: Three risk factors for PPCs have been identified in a population undergoing liver resection: preoperative\nGGT elevation, ischemia duration and the intraoperative use of vasopressor. PPCs after liver surgery could be related to\nlung injury induced by liver ischemia reperfusion and not solely by direct infectious process. That could explain why\nfactors influencing directly or indirectly liver ischemia were independently associated with PPCs.
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