Coagulation and Fibrinolysis During and after Hepatic Lobectomy in 17 Patients

Hepatic lobectomy was performed in 17 patients for tumor (15 cases) or for hepatic cyst (2 cases). With regard to the hepatic lobes resected, there are 2 left lobectomies, 3 right, 9 right extended to the medial segment of the left lobe, 1 atypical resection of the right lobe and 1 of the left lobe, and 1 total hepatectomy followed by hepatic homotransplantation. In 9 patients, laparotomy showed that resection was not possible and they are used as controls.

Blood samples were drawn every 30 minutes during operation, every day or every other day during the two post-operative weeks.

Increased fibrinolytic activity and positive ethanol gelation tests are frequent but transient during surgery. However hemorragic problems are not encountered if hepatectomy is regulated. Routine administration of PPSB, antifibrinolytics or heparin does not seem to be required.

Variations of clotting factors and antithrombin III are observed during the days following surgery.