BACKGROUND: Simultaneous resection of both the liver and the pancreas carries significant complexity. The objective of this study was to investigate peri-operative outcomes after a synchronous hepatectomy and pancreatectomy (SHP). METHODS: The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patients who underwent SHP. Resections were categorized as '< hemihepatectomy', '≥ hemihepatectomy' (hemihepatectomy and trisectionectomy), 'PD' (pancreaticoduodenectomy and total pancreatectomy) and 'distal' (distal pancreatectomy and enucleation). RESULTS: From 2005 to 2013, 480 patients underwent SHP. Patients were stratified based on the extent of resection: '< hemihepatectomy + distal (n = 224)', '≥ hemihepatectomy + distal' (n = 49), '< hemihepatectomy + PD' (n = 83) and '≥ hemihepatectomy + PD' (n = 24). Although the first three groups had a reasonable and comparable safety profile (morbidity 33-51% and mortality 0-6.6%), the '≥ hemihepatectomy + PD' group was associated with an 87.5% morbidity (organ space infection 58.3%, re-intubation 12.5%, reoperation 25% and septic shock 25%), 8.3% 30-day mortality and 18.2% in-hospital mortality. CONCLUSIONS: A synchronous hemihepatectomy (or trisectionectomy) with PD remains a highly morbid combination and should be reserved for patients who have undergone extremely cautious selection.
BACKGROUND: Simultaneous resection of both the liver and the pancreas carries significant complexity. The objective of this study was to investigate peri-operative outcomes after a synchronous hepatectomy and pancreatectomy (SHP). METHODS: The American College of Surgeons National Surgical Quality Improvement Project database was queried to identify patients who underwent SHP. Resections were categorized as '< hemihepatectomy', '≥ hemihepatectomy' (hemihepatectomy and trisectionectomy), 'PD' (pancreaticoduodenectomy and total pancreatectomy) and 'distal' (distal pancreatectomy and enucleation). RESULTS: From 2005 to 2013, 480 patients underwent SHP. Patients were stratified based on the extent of resection: '< hemihepatectomy + distal (n = 224)', '≥ hemihepatectomy + distal' (n = 49), '< hemihepatectomy + PD' (n = 83) and '≥ hemihepatectomy + PD' (n = 24). Although the first three groups had a reasonable and comparable safety profile (morbidity 33-51% and mortality 0-6.6%), the '≥ hemihepatectomy + PD' group was associated with an 87.5% morbidity (organ space infection 58.3%, re-intubation 12.5%, reoperation 25% and septic shock 25%), 8.3% 30-day mortality and 18.2% in-hospital mortality. CONCLUSIONS: A synchronous hemihepatectomy (or trisectionectomy) with PD remains a highly morbid combination and should be reserved for patients who have undergone extremely cautious selection.
Authors: George A Poultsides; Lyen C Huang; Yijun Chen; Brendan C Visser; Reetesh K Pai; R Brooke Jeffrey; Walter G Park; Ann M Chen; Pamela L Kunz; George A Fisher; Jeffrey A Norton Journal: Ann Surg Oncol Date: 2012-03-07 Impact factor: 5.344
Authors: C Max Schmidt; Emilie S Powell; Constantin T Yiannoutsos; Thomas J Howard; Eric A Wiebke; Chad A Wiesenauer; Joel A Baumgardner; Oscar W Cummings; Lewis E Jacobson; Thomas A Broadie; David F Canal; Robert J Goulet; Eardie A Curie; Higinia Cardenes; John M Watkins; Patrick J Loehrer; Keith D Lillemoe; James A Madura Journal: Arch Surg Date: 2004-07
Authors: Hallbera Gudmundsdottir; Ron Pery; Rondell P Graham; Cornelius A Thiels; Susanne G Warner; Rory L Smoot; Mark J Truty; Michael L Kendrick; Thorvardur R Halfdanarson; Elizabeth B Habermann; David M Nagorney; Sean P Cleary Journal: Ann Surg Oncol Date: 2022-06-22 Impact factor: 4.339