Outcomes of extended hepatectomy for hepatobiliary tumors. Initial experience from a non-university hepatobiliary center

Am J Surg. 2020 Jan;219(1):106-109. doi: 10.1016/j.amjsurg.2019.05.007. Epub 2019 May 23.

Abstract

Introduction: Hepatectomy is the gold standard curative treatment for hepatic neoplasms in patients with preserved liver function. Many large tumors require extended hepatectomy (EH). Possibility of developing major postoperative complications including liver failure is feared by many surgeons. We aim to describe our outcomes of EH for large hepatobiliary tumors.

Material and methods: All patients undergoing hepatectomy between 2012 and 2017 were prospectively followed.

Results: 91 patients underwent hepatectomy with ten patients underwent EH. The majority of patients were women, age of 63, BMI of 24, and MELD score of 11. Six patients underwent an extended right hepatectomy, while four patients underwent extended left hepatectomy. Operative time was 224 min with estimated blood loss of 500 ml. No intraoperative complications were seen. Two patients experienced postoperative complications (pleural effusion in one patient and respiratory failure in another). Length of ICU stay was 2 days, and hospital stay was 5 days. 80% of the patients are currently alive with median follow-up of 41.2 months.

Conclusion: EH can be undertaken safely with acceptable morbidity and mortality in our center.

MeSH terms

  • Adult
  • Aged
  • Bile Duct Neoplasms / surgery*
  • Female
  • Hepatectomy / methods*
  • Humans
  • Liver Neoplasms / surgery*
  • Male
  • Middle Aged
  • Neoplasms, Multiple Primary / surgery*
  • Prospective Studies
  • Treatment Outcome