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Updated: May 2, 2026
The Influence of Liver Resection on Intrahepatic Tumor Growth
Published on: April 9, 2016
Morbidity and mortality associated with liver resections for primary malignancies in children
Nathan P Zwintscher1, Kenneth S Azarow, John D Horton
1Department of Surgery, Madigan Army Medical Center, Tacoma, WA, 98431, USA, npzwintscher@gmail.com.
Insights
Pediatric liver resection (LR) for malignancy carries significant risks, with high-volume centers showing increased complication rates but no mortality. Further research is needed to understand these outcomes.
Area of Science:
- Pediatric Surgery
- Surgical Oncology
- Hepatobiliary Surgery
Background:
- Liver resection (LR) is a complex procedure with limited data on short-term outcomes in pediatric patients.
- Understanding outcomes is crucial for optimizing care for children with liver malignancies.
Purpose of the Study:
- To characterize the patient population undergoing LR for malignancy.
- To evaluate the short-term outcomes of pediatric liver resections.
Main Methods:
- Analysis of 126 inpatient admissions for pediatric liver resection (LR) from the 2009 Kids' Inpatient Database.
- Exclusion of transplantations; definition of complications using ICD-9 codes.
- Comparison between high-volume (≥5 LR/year) and low-volume centers.
Main Results:
- Mean patient age was 5.83 years; morbidity was 30.7% and mortality was 3.7%.
- Digestive system complications, anemia, and respiratory issues were most common morbidities.
- High-volume centers had a fourfold increase in complication likelihood (P=0.011) but 0% mortality (P=0.089).
Conclusions:
- Pediatric liver resection (LR) is associated with substantial morbidity and mortality.
- High-volume centers demonstrated increased complication rates compared to low-volume centers, potentially due to resection extent.
Purpose:
Liver resection (LR) is a high-risk procedure with limited data in the pediatric surgical literature regarding short-term outcomes. Our aim was to characterize the patient population and short-term outcomes for children undergoing LR for malignancy.
Methods:
We studied 126 inpatient admissions for children ≤20 years of age undergoing LR in 2009 using the Kids' Inpatient Database. Patients had a principal diagnosis of a primary hepatic malignancy and LR listed as one of the first five procedures. Transplantations were excluded. Complications were defined by ICD-9 codes. High-volume centers performed at least 5 LR.
Results:
The mean age was 5.83 years. The morbidity and mortality rates were 30.7 and 3.7%, respectively. The most common causes of morbidity were digestive system complications (7.4%), anemia (7.3%), and respiratory complications (3.8%). 43.9% received a blood product transfusion. The average length of stay was 10.04 days. When compared to low-volume centers, high-volume centers increased the likelihood of a complication fourfold (P = 0.011) but had 0% mortality (P = 0.089).
Conclusion:
LR remains a procedure fraught with multiple complications and a significant mortality rate. High-volume centers have a fourfold increase in likelihood of complications compared to low-volume centers and may be related to extent of hepatic resection.
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