R Brancatisano1, A Isla, N Habib. 1. Department of Surgery, Royal Postgraduate Medical School, Hammersmith Hospital, London, United Kingdom.
Abstract
BACKGROUND: A prospective review of 200 consecutive liver resections performed for benign and malignant disease, between 1989 and 1995 at the Hammersmith Hospital, was undertaken to evaluate the safety of radical hepatic resection. METHODS: The indications for operation were: hepatocellular carcinoma (n = 39), cholangiocarcinoma (n = 21), gall bladder carcinoma (n = 8), colorectal secondaries (n = 75), noncolorectal secondaries (n = 35), and benign disease (n = 26). Twenty patients were cirrhotic and 36 were jaundiced. Major resections were performed in 74% of cases and included 63 extended hepatectomies, 17 repeated resections for recurrent colorectal metastases, and 17 resections combined with vascular reconstruction. Total vascular exclusion of the liver was used in the majority of cases. RESULTS: The overall mortality rate was 5%. Thirty-day mortality was 2.5%. Sepsis and not hemorrhage was the most common cause of death. There were 101 complications that occurred in 37% of the patients. The main complications were subphrenic abscess and biliary leak. The extent of liver resection (major versus minor) significantly increased the risk of morbidity (46% versus 16%). Blood loss greater than 100 mL increased the risk of morbidity from 12% to 25%. CONCLUSIONS: Major hepatic resection can be achieved with acceptable mortality but high morbidity rates.
BACKGROUND: A prospective review of 200 consecutive liver resections performed for benign and malignant disease, between 1989 and 1995 at the Hammersmith Hospital, was undertaken to evaluate the safety of radical hepatic resection. METHODS: The indications for operation were: hepatocellular carcinoma (n = 39), cholangiocarcinoma (n = 21), gall bladder carcinoma (n = 8), colorectal secondaries (n = 75), noncolorectal secondaries (n = 35), and benign disease (n = 26). Twenty patients were cirrhotic and 36 were jaundiced. Major resections were performed in 74% of cases and included 63 extended hepatectomies, 17 repeated resections for recurrent colorectal metastases, and 17 resections combined with vascular reconstruction. Total vascular exclusion of the liver was used in the majority of cases. RESULTS: The overall mortality rate was 5%. Thirty-day mortality was 2.5%. Sepsis and not hemorrhage was the most common cause of death. There were 101 complications that occurred in 37% of the patients. The main complications were subphrenic abscess and biliary leak. The extent of liver resection (major versus minor) significantly increased the risk of morbidity (46% versus 16%). Blood loss greater than 100 mL increased the risk of morbidity from 12% to 25%. CONCLUSIONS: Major hepatic resection can be achieved with acceptable mortality but high morbidity rates.
Authors: G Navarra; A Ayav; J-C Weber; S L Jensen; C Smadga; J P Nicholls; N A Habib; L R Jiao Journal: Int J Colorectal Dis Date: 2005-04-28 Impact factor: 2.571
Authors: A Loganathan; J E Linley; I Rajput; M Hunter; J P A Lodge; G I Sandle Journal: Am J Physiol Gastrointest Liver Physiol Date: 2010-10-21 Impact factor: 4.052
Authors: Bernard J DuBray; Kendra D Conzen; Gundumi A Upadhya; Parvathi Balachandran; Jianluo Jia; Brett L Knolhoff; David H Alpers; Thallachallour Mohanakumar; William C Chapman; Christopher D Anderson Journal: Surgery Date: 2012-06-13 Impact factor: 3.982
Authors: Elijah Dixon; Oliver F Bathe; Andrew McKay; Isabelle You; Scot Dowden; David Sadler; Kelly W Burak; J Gregory McKinnon; Walter Miller; Francis R Sutherland Journal: Can J Surg Date: 2009-02 Impact factor: 2.089