Hepatic resection without mortality at a community hospital

The mortality of elective hepatic resections is now below 5%, and the improved result has been attributed partly to performance of such operations at high-volume specialized units. We retrospectively studied 60 consecutive elective hepatic resections performed during a 2-year period between April 1998 and March 2000 at a Red Cross community hospital. There was no hospital mortality and morbidity occurred in 20 patients (33.3%). High morbidity was associated with concomitant surgical procedures, especially ones with contamination of the operative field such as biliary and gastric surgery, but not with colonic procedures. Hepatic resections for primary and secondary malignancy, as well as benign diseases, can be performed without mortality at community hospitals, provided that adequate selection criteria is used and appropriate operative and postoperative management are available.