There have been recent developments in surgery and patient management during the perioperative period.
However, critical complications still developed in a few patients who had hepatic resection for hepatocellular carcinoma.
Dr Akinobu Taketomi and colleagues from Japan reviewed 625 consecutive patients who had hepatic resection for hepatocellular carcinoma.
The investigators also assessed operative morbidity, and mortality rates.
The investigative team found there were progressive decreases in the surgical blood loss, and the rate of blood transfusion.
Occurrence of ascites and other complications dramatically decreased in the study series.
|From 1997 to 2002, postoperative liver failure reduced by 1%|
|Journal of American College of Surgeons|
The team found that hospital death rate, and incidence of postoperative liver failure reduced from 3% to 2% between 1985 and 1990.
Between 1991 and 1996, the incidence of postoperative liver failure was reduced from 4% to 3%.
The investigators observed that from 1997 to 2002, the incidence of postoperative liver failure reduced from 2% to 1%.
The team identified independent risk factors using multiple logistic regression.
Independent risk factors associated with postoperative complications were found to be the period of operation.
Alanine aminotransferase levels of 70 IU/L was also an independent risk factor of postoperative complications.
The investigators noted that a platelet count less than 100 × 103/mm3 was an independent risk factor.
In addition, the presence of blood transfusion during operation from 1997 to 2002 was an independent risk factor of complications.
Dr Taketomi's team concluded, “In this series, there has been a decline in surgical blood loss and rate of blood transfusion and in the number of patients with major complications.”
“These results are largely attributable to the adequate selection of surgical candidate and factors aimed at reducing surgical blood loss.”