Background There is no consensus on how to best achieve a low central venous pressure during hepatectomy for the purpose of reducing blood loss and red blood cell (RBC) transfusions. We analyzed the associations between intraoperative hypovolemic phlebotomy (IOHP), transfusions, and postoperative outcomes in cancer patients undergoing hepatectomy. Methods Using surgical and transfusion databases of patients who underwent hepatectomy for cancer at one institution (11 January 2011 to 22 June 2017), we retrospectively analyzed associations between IOHP and RBC transfusion on the day of surgery (primary outcome), and with total perioperative transfusions, intraoperative blood loss, and postoperative complications (secondary Maher Al Khaldi and Filip Gryspeerdt-Co-first authors, equal contribution.

In the pregnant patient, HCA represents a significant diagnostic and therapeutic challenge. Anatomically favorable located lesions can be safely managed with laparoscopic liver resection. We suggest that laparoscopic liver resection should be considered as part of the currently available strategies for HCA during pregnancy.

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multilocular abscesses (Type III) had significantly lower failure rates following algorithmic approach with primary surgical treatment (3/32) compared to first-line antibiotics or percutaneous drainage (24/80) (9.3% versus 30.0%, p=0.021) with no 30-day mortalities for either group. Large unilocular abscesses (Type II) failed first-line percutaneous drainage in 25.5% (13/51), with 10 patients requiring escalation to surgery. Treatment of Type II abscesses with primary surgery rather than percutaneous drainage was successful in 88.2% (15/17) with no 30-day mortalities. Conclusion: Primary surgical intervention is highly successful in the treatment of large pyogenic liver abscesses. While antibiotic therapy remains the mainstay of treatment for small acute liver abscesses, in light of higher failure rates for percutaneous drainage we propose that surgical intervention should be considered for select patients with large complex abscesses as up-front definitive treatment.