BACKGROUND/AIMS: Hepatic resection for hepatocellular carcinoma (HCC) is associated with a relatively high morbidity rate. This study investigated risk factors for morbidity after resection of HCC that were related to perioperative management and operative techniques. METHODOLOGY: Five hundred and thirty HCC patients who underwent hepatectomy between 1992 and 2008 were divided into three groups: 51 patients with infectious complications during their hospital stay (infectious group), 67 patients with non-infectious complications (non-infectious group) and 412 patients without complications who were discharged within 21 days after hepatectomy (uncomplicated group). RESULTS: Non-infectious complications decreased significantly over time. Although infectious complications also decreased, the change was not significant. The overall survival rate of the groups with complications was significantly worse than that of the uncomplicated group (p<0.0005). Univariate and multivariate analyses showed that an operating time >300min and bile leakage were independent risk factors for infectious complications, while a platelet count ≤13x104/mL, cirrhosis and operative blood loss >1,000mL were risk factors for non-infectious complications. CONCLUSIONS: To achieve zero morbidity, it is important to avoid bile leakage and minimize blood loss during resection of HCC in patients with cirrhosis.
BACKGROUND/AIMS: Hepatic resection for hepatocellular carcinoma (HCC) is associated with a relatively high morbidity rate. This study investigated risk factors for morbidity after resection of HCC that were related to perioperative management and operative techniques. METHODOLOGY: Five hundred and thirty HCC patients who underwent hepatectomy between 1992 and 2008 were divided into three groups: 51 patients with infectious complications during their hospital stay (infectious group), 67 patients with non-infectious complications (non-infectious group) and 412 patients without complications who were discharged within 21 days after hepatectomy (uncomplicated group). RESULTS: Non-infectious complications decreased significantly over time. Although infectious complications also decreased, the change was not significant. The overall survival rate of the groups with complications was significantly worse than that of the uncomplicated group (p<0.0005). Univariate and multivariate analyses showed that an operating time >300min and bile leakage were independent risk factors for infectious complications, while a platelet count ≤13x104/mL, cirrhosis and operative blood loss >1,000mL were risk factors for non-infectious complications. CONCLUSIONS: To achieve zero morbidity, it is important to avoid bile leakage and minimize blood loss during resection of HCC in patients with cirrhosis.
Authors: Robert Öllinger; Andre L Mihaljevic; Christoph Schuhmacher; Hüseyin Bektas; Florian Vondran; Moritz Kleine; Mauricio Sainz-Barriga; Sascha Weiss; Phillip Knebel; Johann Pratschke; Roberto I Troisi Journal: HPB (Oxford) Date: 2012-12-27 Impact factor: 3.647