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Hepatic resection: a safe and effective surgery
David Calatayud1, Santiago Sánchez Cabús1, Jaime Sampson1
1Unidad de Cirugía HPB y Trasplantes, ICMDiM, Hospital Clínic de Barcelona, Barcelona, España.
Cirugia Espanola
|August 19, 2017
Summary
Major liver resections are increasingly safe and effective, with low complication rates. Surgical advancements allow for complex procedures, with outcomes depending on residual liver volume.
Area of Science:
- Hepatobiliary Surgery
- Surgical Oncology
- Gastroenterology
Background:
- Major liver resections have seen increased surgical activity over the past decades.
- Perioperative outcomes of these complex procedures require continuous evaluation.
- Comparative analyses across different time periods highlight evolving surgical practices.
Purpose of the Study:
- To evaluate perioperative results of major liver resections.
- To identify factors associated with major postoperative complications.
- To compare outcomes across different 25-year periods.
Main Methods:
- Retrospective analysis of 416 major hepatic resections (≥3 segments) from 2005-2014.
- Inclusion of pre, intra, and postoperative data.
- Utilized Clavien classification for postoperative morbidity assessment.
Main Results:
- Half of patients experienced no complications; 23% had major complications.
- Bile leakage (17.3%) was the most frequent complication.
- Liver failure occurred in 13 patients, with 7 deaths (5 linked to infection).
Conclusions:
- Liver surgery has significantly increased, demonstrating improved safety and efficacy.
- Low complication rates are achievable with modern surgical management.
- Residual hepatic volume remains a critical factor in determining resectability limits.
