Mortality associated with liver resection is greater than 2% in most of the recent studies.
However, by refining preoperative and postoperative care and surgical skills, mortality can be reduced to zero.
In this study, doctors from Japan analyzed postoperative morbidity and mortality in 1056 consecutive hepatectomies performed at a single center over an 8-year period.
|Major complications occurred in 3% of patients with hepatocellular carcinoma.|
|Archives of Surgery|
A total of 915 patients underwent 1056 consecutive hepatic resections.
Of these, 532 were for hepatocellular carcinoma, 262 for other liver malignancies, 57 for biliary tract malignancy, 174 for living donor transplantation, and 31 for benign disease.
The doctors measured operative mortality and morbidity rates.
There was no operative mortality during the 8-year period.
The team identified major complications in 3% of patients with hepatocellular carcinoma, 8% with other malignancy, 28% with biliary malignancy, and in 5% of living donors.
Risk factors for complications included operative blood loss of ≥1000 mL for hepatocellular carcinoma, and total bilirubin of ≥1.0 mg/dL and operative time >6 hours for other malignancies.
The team was unable to identify any factors associated with major complications for biliary malignancy or for living donor liver transplantation donors.
Dr Hiroshi Imamura's team concluded, "Liver resection can be performed without mortality provided that it is carried out in a high-volume medical center by well-trained hepatobiliary surgeons".