Laparoscopic liver resection for patients with cardiac disease

Yoshihiro Inoue; Syuji Kagota; Yusuke Tsuchimoto; Takeshi Ogura; Akira Asai; Shinya Fukunishi; Kazuhide Higuchi; Kazuhisa Uchiyama

doi:10.5114/wo.2019.84109

eISSN: 1897-4309
ISSN: 1428-2526

Contemporary Oncology/Współczesna Onkologia

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1/2019
vol. 23

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abstract:

Original paper

Laparoscopic liver resection for patients with cardiac disease

Yoshihiro Inoue

¹

,

Syuji Kagota

¹

,

Yusuke Tsuchimoto

²

,

Takeshi Ogura

²

,

Akira Asai

²

,

Shinya Fukunishi

²

,

Kazuhide Higuchi

²

,

Kazuhisa Uchiyama

¹

Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, Takatsuki, Osaka, Japan
Second Department of Internal Medicine, Osaka Medical College Hospital, Takatsuki, Osaka, Japan

Contemp Oncol (Pozn) 2019; 23 (1): 37-42

DOI: https://doi.org/10.5114/wo.2019.84109

Online publish date: 2019/04/05

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Introduction
The gravest problem facing medicine is caring for an aging society and the comorbidities that develop with age, including an increasing prevalence of cardiac disease. Unrecognized or untreated cardiac disease increases the risk of complications in patients undergoing laparoscopic liver resection (LLR). We herein describe the preoperative status, perioperative outcomes, and postoperative courses of patients with or without cardiac disease who undergo LLR.

Material and methods
The data of 339 patients who underwent LLR at a single institution between 2010 and 2018 were retrospectively reviewed. Their preoperative status, surgical outcomes, and postoperative courses were analyzed.

Results
Of 339 patients who underwent LLR, one was excluded for pre-existing severe valvular disease. Of the remaining 338 patients, 16 had coexisting cardiac disease and 322 did not. The patients with coexisting cardiac disease had a mean left ventricular ejection fraction of 66% (22–74%). LLR was performed after cardiac function was controlled in the patients with cardiac disease; there were no instances of increased central venous pressure (CVP) or destabilized vital signs during surgery. Intraoperative CVP did not differ between the groups (p = 0.521). There were no significant differences in the demographics except for age, operative characteristics, and surgical outcomes between the groups.

Conclusions
Patients with non-severe or controlled severe cardiac disease do not exhibit different postoperative courses compared to patients without coexisting cardiac disease. Uncontrolled severe cardiac disease can lead to unstable vital signs during surgery, such as increased CVP. In such cases, treating the cardiac disease should be prioritized.

keywords:

Laparoscopic liver resection for patients with cardiac disease

Yoshihiro Inoue 1 , Syuji Kagota 1 , Yusuke Tsuchimoto 2 , Takeshi Ogura 2 , Akira Asai 2 , Shinya Fukunishi 2 , Kazuhide Higuchi 2 , Kazuhisa Uchiyama 1

laparoscopic liver resection, cardiac disease, central venous pressure

Yoshihiro Inoue

¹

,

Syuji Kagota

¹

,

Yusuke Tsuchimoto

²

,

Takeshi Ogura

²

,

Akira Asai

²

,

Shinya Fukunishi

²

,

Kazuhide Higuchi

²

,

Kazuhisa Uchiyama

¹