Predictors of early postoperative outcomes in 375 consecutive hepatectomies: A single-institution experience

Mohammad Ali Abbass, Jeffery M. Slezak, L. Andrew Difronzo*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Scopus citations

Abstract

Although the safety of hepatic resection has improved, it is still a highly morbid procedure. A retrospective cohort of 375 patients undergoing hepatectomy (2004 to 2012) was done. All procedures were performed by a single surgeon at a tertiary center. To help identify trends over time, two subgroupswere identified: Group 1 (n5195 fromOctober 2004 to December 2010) and Group 2 (n5 180 from January 2011 to November 2012). The two study groups had similar patient characteristics except there weremore patientswith cirrhosis in Group 2 (10 vs 17%, P = 0.04). A similar number of major hepatectomies was noted. Median estimated blood loss was 400 mL versus 300 mL (P = 0.04) in Group 2. Overall complications were more common in Group 1 (54 vs 45%). Fewer Grade 3 or greater Clavien complications (22 vs 13%, P = 0.04) and fewer hospital readmissions were noted in Group 2 (20 vs 8%, P = 0.002). Morbidity was associated with worse Eastern Cooperative Oncology Group (ECOG) performance status, age older than 60 years, and open surgery. Grade 3 or greater Clavien complications were also associated with age older than 60 years, higherAmerican Society of Anesthesiologists class, and worse ECOG status and median estimated blood less greater than 400 mL. Higher Model for End-stage Liver Disease score and advanced ECOG status were correlated with mortality. Outcomes of hepatic resection improved time despite more complex patient characteristics and an equal number of major hepatectomies being performed. However, worse ECOG performance status was a major predictor of postoperative complications and increased mortality.

Original languageEnglish (US)
Pages (from-to)961-967
Number of pages7
JournalAmerican Surgeon
Volume79
Issue number10
StatePublished - Oct 2013
Externally publishedYes

ASJC Scopus subject areas

  • Surgery

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