Hepatic Insufficiency and Mortality in 1,059 Noncirrhotic Patients Undergoing Major Hepatectomy

Mullen, John; Ribero, Dario; Reddy, Srinevas K.; Donadon, Matteo; Zorzi, Daria; Gautam, Shiva; Abdalla, Eddie K.; Curley, Steven A.; Capussotti, Lorenzo; Clary, Bryan M.; Vauthey, Jean Nicolas

doi:10.1016/j.jamcollsurg.2006.12.032

Cited by 584 publications

(520 citation statements)

References 30 publications

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“…Secondly, patients in the groups of right and left hepatic lobectomy were evenly matched for demographics, general variables, functional status, pre-operative co-morbidities and pre-operative laboratory values specific for hepatic and renal function. Finally, the overall 30-day mortality and morbidity rate noted for the entire cohort of patients was 3.12 and 32.11 % respectively, which is congruent with the currently accepted standards and similar to other seminal published reports [6,22,23]. This similarity in the rates of mortality and morbidity attests to the robustness of the included data, which thereby adds strength to the conclusions derived from this study.…”

Section: Discussionsupporting

confidence: 90%

Differences in Perioperative Outcomes Between Right and Left Hepatic Lobectomy

Douaiher

Dhir

Smith

et al. 2015

Indian J Surg Oncol

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The safety of hepatic resection is well documented, but outcome studies comparing right and left hepatic lobectomy are sparse, especially in the context of malignancy. This study analyzes the differences in outcomes between right and left hepatic lobectomy in patients with malignant diagnoses. All patients undergoing right and left hepatic lobectomies for malignancy were extracted from the National Surgical Quality Improvement Program (NSQIP) database (2005)(2006)(2007)(2008)(2009)(2010). The data was analyzed to determine differences in perioperative mortality and morbidity between the two groups. A total of 1680 patients who underwent right or left hepatic lobectomy for malignant diagnoses were identified. Patients undergoing right hepatic lobectomy had a four-fold increase in perioperative mortality, compared to left lobectomy (p<0.0001). Mortality in right lobectomy patients increased incrementally with age, with a 12-fold increase in patients>81 years of age. Patients undergoing right lobectomy also experienced a statistically significant increase in morbidity involving several systems (infectious, pulmonary, cardiac and renal). The results of our study demonstrate that patients undergoing right hepatic lobectomy for malignancy experience a significantly higher incidence of mortality and multisystem morbidity when compared to left lobectomy. This information will be crucial for pre-operative risk-stratification of patients undergoing hepatic resection for malignancy.

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Section: Discussionsupporting

confidence: 90%

Differences in Perioperative Outcomes Between Right and Left Hepatic Lobectomy

Douaiher

Dhir

Smith

et al. 2015

Indian J Surg Oncol

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show abstract

“…Recently, liver stiffness measurement (LSM) using FibroScan has shown a considerable accuracy in assessing liver fibrosis in patients with CLD [8][9][10]. Accordingly, in our previous study, we hypothesized that preoperative assessment of liver fibrosis using LSM might predict postoperative hepatic insufficiency after liver resection and proved the potential usefulness of LSM as a non-invasive preoperative method for evaluating functional liver reserve [11].…”

Section: Introductionmentioning

confidence: 99%

Can preoperative diffusion-weighted MRI predict postoperative hepatic insufficiency after curative resection of HBV-related hepatocellular carcinoma? A pilot study

Kim

Choi

et al. 2010

Magnetic Resonance Imaging

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“…Today colorectal cancer liver metastases have, at least in Western countries, become the most common indication for liver resection, and chemotherapy is used with increasing frequency for down-staging or in neoadjuvant settings. Although not all agents have been studied, some have shown to be hepatotoxic, resulting in sinusoidal obstruction syndrome and chemotherapyassociated steatohepatitis, associated with a higher morbidity and in some cases even mortality after surgery [1,43]. Non-alcoholic fatty liver disease has become the most common chronic liver disease in the Western world, with between 10% and 20% of the patients progressing to non-alcoholic steatohepatitis, which may in turn lead to liver cirrhosis [44][45][46].…”

Section: Discussionmentioning

confidence: 99%

“…In patients undergoing liver resection, post-operative liver failure is a major concern and has in current practice become the biggest cause for mortality after liver resection [1][2][3]. Residual liver should be of adequate volume and quality to sustain immediate post-operative function and to allow regeneration for complete restoration of hepatic function.…”

mentioning

confidence: 99%