BackgroundHepatic resection has evolved to become safer, thereby making it possible to expand the indications.AimTo assess the results from a group of patients presenting these expanded indications.MethodWere prospectively studied all the hepatectomy procedures performed for hepatic tumor resection. Patients with benign and malignant primary and secondary tumors were included. Were included variables such as age, gender, preoperative diagnosis, preoperative treatment, type of operation performed, need for transfusion, final anatomopathological examination and postoperative evolution. The patients were divided into two groups: group A, with a traditional indication for hepatectomy; and group B, with an expanded indication (tumors in both hepatic lobes, extensive resection encompassing five or more segments, cirrhotic livers and postoperative chemotherapy using hepatotoxic drugs).ResultsWere operated 38 patients, and 40 hepatectomies were performed: 28 patients in group A and 10 in group B. The mean age was 57.7 years, and 25 patients were women. Three in group B were operated as two separate procedures. Groups A and B received means of 1.46 and 5.5 packed red blood cell units per operation, respectively. There were three cases with complications in group A (10.7%) and six in group B (60%). The mortality rate in group A was 3.5% (one patient) and in groups B, 40% (four patients). The imaging examinations were sensitive for the presence of tumors but not for defining the type of tumor. The blood and derivative transfusion rates, morbidity and mortality were greater in the group with expanded indications and more extensive surgery.ConclusionThe indications for liver biopsy and portal vein embolization or ligature can be expanded, with special need of cooperation of the anesthesiology department and the use of hepatic resection devices to diminish blood transfusion.

-Background -Changes in digestion and nutrients losses are relevant aspects in weight reduction and maintenance of the nutritional status of patients undergoing gastroplasty, but few studies are available in the literature. Aim -To study the systemic changes arising from the reduction in weight over time after surgery. 28,93 and 35,89). The percentage of weight reduction at this stage was 36,31% (p>0,001), one patient had weight gain, in three (6,8%) patients the albumin level was reduced and nine had anemia. The faecal fat was positive in 16 patients (36,4%), reducing substance in stool was positive in one patient and the presence of faecal occult blood was positive in 13 patients (29,5%). The internal diameter of the silicon ring was between 0,45 and 1,4 cm (mean 0,75, SD = 0,22). Conclusion -After surgery there is a significant weight loss, but the BMI is still above 35 kg/m² in 26 patients (59%), followed for a long time. There is a substantial improvement in cholesterol and glucose blood levels. The diameter of ring in the small stomach showed no significant association with weight reduction, while patients with greater than 1 cm ring did not show anemia or low levels of albumin, clinically better than those with rings smaller than 1 cm.RESUMO -Racional -As alterações na digestão e perdas de nutrientes são aspectos relevantes na redução do peso e na manutenção do estado nutricional do paciente submetido à gastroplastia, mas poucos estudos estão disponíveis na literatura. Objetivo -Estudar as alterações sistêmicas decorrentes da redução de peso ao longo do tempo, após o tratamento cirúrgico.