J.Jpn. Surg. Soc.. 88(9): 1188-1191, 1987

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Report on the annual meeting

PATHOPHYSIOLOGY OF HEMORRHAGIC SHOCK IN THE EXTENDED HEPATECTOMY AND MANAGEMENT OF POSTOPERATIVE G1 BLEEDING

1. Clinical studies ; ① Postoperative multiple organ failures (MOF) developed in 13.2％ of hepatectomies associated with liver cirrhosis, while they were in 2.2％ of hepatectomies without cirrhosis. ② Postoperative upper GI bleeding was observed in 18.4％ of hepatectomies and the incidence increased in the MOF after hepatectomies.
2. Experimental studies ; ① In hepatectomy under hemorrhagic shock, the prognosis was worse in shock caused by bleeding from portal vein than in shock caused by bleeding from artery. ② In the groups transfused with the maintenance dose or large volumes of lactated Ringer’s solution, or large volumes of Dextran 40 after 80％ and 70％ hepatectomy in normal dog and 40％ hepatectomy in Dimethylnitrosamine-induced cirrhotic dog, the extravascular lung water (EVLW) increased with high rate of development of lung edema. On the other hand, in the groups transfused with the maintenance dose or large volumes of 10％ Dextrose, or the maintenance dose of Dextran 40, EVLW did not increase, without development of lung edema. ③ When a large dose of Decardron was administered in rats prior to cold restraint, ulcer-formations in the stomach were prevented.

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