Faculty Collaboration Database

Clinical outcomes of left hepatic trisectionectomy for hepatobiliary malignancy. Br J Surg 2016 Feb;103(3):249-56

Date

12/24/2015

Pubmed ID

26695377

DOI

10.1002/bjs.10059

Scopus ID

2-s2.0-84955401452 (requires institutional sign-in at Scopus site)   20 Citations

Abstract

BACKGROUND: Left hepatic trisectionectomy (LHT) is a challenging major anatomical hepatectomy with a high complication rate and a worldwide experience that remains limited. The aim of this study was to describe changes in surgical practice over time, to analyse the outcomes of patients undergoing LHT for hepatobiliary malignancy, and to identify factors associated with morbidity and mortality.

METHODS: A cohort study was undertaken of patients who underwent LHT at a single tertiary hepatobiliary referral centre between January 1993 and March 2013. Univariable and multivariable analysis was used to identify factors associated with short- and long-term outcomes following LHT.

RESULT: Some 113 patients underwent LHT for colorectal liver metastasis (57), hilar cholangiocarcinoma (22), intrahepatic cholangiocarcinoma (12) and hepatocellular carcinoma (11); 11 patients had various other indications. Overall morbidity and 90-day mortality rates were 46.0 and 9.7 per cent respectively. Overall 1- and 3-year survival rates were 71.3 and 44.4 per cent respectively. Total hepatic vascular exclusion and intraoperative blood transfusion were independent predictors of postoperative morbidity, whereas blood transfusion was the only factor predictive of in-hospital mortality. Time period analysis revealed a decreasing trend in blood transfusion, duration of hospital stay, and postoperative morbidity and mortality in the last 5 years.

CONCLUSION: Morbidity, mortality and long-term survival after LHT support its use in selected patients with a significant tumour burden.

Author List

Farid SG, White A, Khan N, Toogood GJ, Prasad KR, Lodge JP

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms
Carcinoma, Hepatocellular
Child
Cholangiocarcinoma
Female
Follow-Up Studies
Hepatectomy
Humans
Incidence
Length of Stay
Liver Neoplasms
Male
Middle Aged
Postoperative Complications
Retrospective Studies
Survival Rate
Treatment Outcome
United Kingdom
Young Adult