Liver resection, compared with other abdominal operations, is characterized by greater predisposition to septic complications. This may be explained by several factors, including the major role of the liver in immune defence, anatomical features such as the close relationship of the hepato‑biliary system with the intestine, underlying liver disease if present and specific preoperative treatments favouring postoperative sepsis. A critical point is that sepsis does not always present with immediately recognizable signs, such as fever or leukocytosis. At times it presents with more subtle signs, for instance hyperbilirubinemia and encephalopathy. After liver resection these may be misinterpreted as simple consequences of transient parenchymal insufficiency, therefore resulting in failure to recognize and promptly treat underlying sepsis. Particular caution is needed in this setting to avoid dismal outcomes. This chapter focuses on these aspects, describing underlying mechanisms and preventive measures and further characterizing the powerful synergism of sepsis overimposed on postoperative liver dysfunction in determining poor outcome.

Nuzzo, G., Giovannini, I., Giuliante, F., Ardito, F., Chiarla, C., Sepsis after liver resection:Predisposition, clinical relevance and synergism with liver dysfunction, in Dionigi, R. (ed.), Recent Advances in Liver Surgery, Landes Bioscience, Austin, Texas (USA), Austin, Texas, USA 2008: 245- 259 [http://hdl.handle.net/10807/14671]

Sepsis after liver resection: Predisposition, clinical relevance and synergism with liver dysfunction

Nuzzo, Gennaro;Giovannini, Ivo;Giuliante, Felice;Ardito, Francesco;Chiarla, Carlo
2008

Abstract

Liver resection, compared with other abdominal operations, is characterized by greater predisposition to septic complications. This may be explained by several factors, including the major role of the liver in immune defence, anatomical features such as the close relationship of the hepato‑biliary system with the intestine, underlying liver disease if present and specific preoperative treatments favouring postoperative sepsis. A critical point is that sepsis does not always present with immediately recognizable signs, such as fever or leukocytosis. At times it presents with more subtle signs, for instance hyperbilirubinemia and encephalopathy. After liver resection these may be misinterpreted as simple consequences of transient parenchymal insufficiency, therefore resulting in failure to recognize and promptly treat underlying sepsis. Particular caution is needed in this setting to avoid dismal outcomes. This chapter focuses on these aspects, describing underlying mechanisms and preventive measures and further characterizing the powerful synergism of sepsis overimposed on postoperative liver dysfunction in determining poor outcome.
2008
Inglese
Recent Advances in Liver Surgery
978-1-58706-317-6
Nuzzo, G., Giovannini, I., Giuliante, F., Ardito, F., Chiarla, C., Sepsis after liver resection:Predisposition, clinical relevance and synergism with liver dysfunction, in Dionigi, R. (ed.), Recent Advances in Liver Surgery, Landes Bioscience, Austin, Texas (USA), Austin, Texas, USA 2008: 245- 259 [http://hdl.handle.net/10807/14671]
File in questo prodotto:
Non ci sono file associati a questo prodotto.

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/10807/14671
Citazioni
  • ???jsp.display-item.citation.pmc??? ND
  • Scopus ND
  • ???jsp.display-item.citation.isi??? ND
social impact