Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Dumitraşcu, Traian; Brasoveanu, Vladislav; Stroescu, Cezar; Ionescu, M; Popescu, Irinel

doi:10.1016/j.asjsur.2015.04.007

Cited by 23 publications

(40 citation statements)

References 40 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The large variability of reported liver failure rates might be significantly influenced by the variations in the definition of liver failure. Thus, the postoperative liver failure rates after hepatectomies appear to be higher when the ISGLS definition is used (14,23), as it was the case in the present series. Nagino and coworkers, in a single-center experience of 574 patients with curative-intent surgery for PHC with and without a PVR, reported a postoperative liver failure rate of 53.5% using the ISGLS definition (11).…”

Section: Discussionsupporting

confidence: 55%

“…The practice of curative-intent surgery and the safety of a PVR in PHC in East European countries is poorly known because very few studies were published (3,8,14,(34)(35)(36)(37). The experience gained in our surgical center with curative-intent surgery for PHC has been reflected in previous publications (3,8,14,38).…”

Section: Introductionmentioning

confidence: 99%

“…The experience gained in our surgical center with curative-intent surgery for PHC has been reflected in previous publications (3,8,14,38).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, the 5-year survival rates of up to 40.4% were reported in large recent series of patients resected for PHC, with up to 73% morbidity and up to 14.3% 90-day mortality rates (8). Postoperative liver failure and bile leak are the most frequent complications after major hepatectomies for PHC (7,14).…”

Section: Introductionmentioning

confidence: 99%

“…A multidisciplinary approach in experienced surgical centers is mandatory to mitigate both morbidity and mortality rates and to obtain improved survivals in patients with PHC (3,5,8,11,14,15). A PHC should be preoperatively differentiated from a benign Klatskin-mimicking lesion to avoid unnecessary extensive resections, albeit the differentiation between the two entities remains challenging (16).…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Dumitraşcu¹,

Stroescu²,

Brasoveanu³

et al. 2017

chr

Self Cite

View full text Add to dashboard Cite

Introducere: Siguranţa rezecţiei de venă portă în chirurgia colangiocarcinoamelor perihilare a fost deja dovedită în Asia, America şi Europa de Vest. Totuşi, nu există nici un fel de date referitoare la acest subiect, care să provină din Europa de Est. Scopul studiului este de a evalua comparativ rezultatele postoperatorii imediate şi pe termen lung după rezecţia cholangiocarcinoamelor perihilare, cu şi fără rezecţie de venă portă. Pacienţi şi metode: Datele a 21 de pacienţi rezecaţi pentru colangiocarcinoame perihilare ce au asociat rezecţia venei porte au fost comparate cu datele a 102 pacienţi fără rezecţie de venă portă. Pentru analiza comparativă a datelor din cele două grupuri s-au folosit teste statistice specifice. Rezultate: Rezecţia venei porte a fost realizată la 17% dintre pacienţi. În grupul pacienţilor cu rezecţie asociată de venă portă au fost realizate semnificativ mai multe trisecţionectomii drepte (p = 0.031) şi rezecţii de lob caudat (p = 0.049). Ca urmare, atât timpul operator (p = 0.015) cât şi pierderea de sânge intraoperator (p = 0.002) au fost semnificativ mai mari în acest grup de pacienţi cu rezecţie de venă portă. Nu s-au constatat diferenţe semnificative între cele două grupuri de pacienţi în ceea ce priveşte rata complicaţiilor severe postoperatorii, mortalitatea postoperatorie şi chimioterapia adjuvantă. Totuşi, în grupul pacienţilor cu rezecţie de venă portă, rata insuficenţei hepatice postoperatorii cu impact clinic

show abstract

Section: Discussionsupporting

confidence: 55%

Section: Introductionmentioning

confidence: 99%

“…The experience gained in our surgical center with curative-intent surgery for PHC has been reflected in previous publications (3,8,14,38).…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Dumitraşcu¹,

Stroescu²,

Brasoveanu³

et al. 2017

chr

Self Cite

View full text Add to dashboard Cite

show abstract

Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

et al. 2023

View full text Add to dashboard Cite

ObjectivePostoperative bile leakage (POBL) is one of the most common complications after liver resection. However, current studies on the risk factors for POBL and their impacts on surgical outcomes need to be more consistent. This study aims to conduct a meta‐analysis to analyze the risk factors for POBL after hepatectomy.MethodsWe incorporated all eligible studies from Embase, PubMed, and the Web of Science database (until July 2022) into this study. RevMan and STATA software were used to analyze the extracted data.ResultsA total of 39 studies, including 43,824 patients, were included in this meta‐analysis. We found that gender, partial hepatectomy, repeat of hepatectomy, extended hepatectomy, abdominal drain, diabetes, Child≥B, solitary tumor, and chemotherapy are the factors of grade B and C POBL. Some recognized risk factors were considered potential risk factors for grade B and C bile leakage because no subgroup analysis was performed, like HCC, cholangiocarcinoma, major resection, posterior sectionectomy, bi‐segmentectomy, S4 involved, S8 involved, central hepatectomy, and bile duct resection/reconstruction. Meanwhile, cirrhosis, benign diseases, left hepatectomy, and Segment 1 resection were not significant for grade B and C bile leakage. The influence of lateral sectionectomy, anterior sectionectomy, S1 involved, S3 involved, high‐risk procedure, laparoscope, and blood loss>1000 mL on POBL of ISGLS needs further research. Meanwhile, POBL significantly influenced overall survival (OS) after liver resection.ConclusionsWe identified several risk factors for POBL after hepatectomy, which could prompt the clinician to decrease POBL rates and make more beneficial decisions for patients who underwent the hepatectomy.

show abstract

A Systematic Review and Meta‐Analysis of Oncologic Liver Resections in Low‐ and Middle‐Income Countries: Opportunities to Improve Evidence and Outcomes

Khan,

Mahmud,

Fatimi

et al. 2024

Journal of Surgical Oncology

View full text Add to dashboard Cite

BackgroundPatients in low‐ and middle‐income countries (LMICs) are disproportionately affected by liver cancers but there is a lack of understanding of their postoperative outcomes. This study aimed to review the current status of research in LMICs regarding outcomes after oncologic hepatectomy and synthesize the data reported in the literature.MethodsThe PubMed, Scopus, Embase, Web of Science, and World Health Organization (WHO) Global Index Medicus databases were searched from database inception to May 26th, 2022. Studies that reported outcomes after oncologic hepatectomy in LMIC settings were eligible for inclusion. Two independent reviewers performed record screening and data extraction. Risk of bias assessment was performed using the National Institutes of Health Study Quality Assessment tools. Pooled results with 95% confidence intervals (95% CIs) were calculated using a random effects model.ResultsOne hundred and thirty‐five studies and 16 985 patients were included. Most studies were of a “fair” quality. Two studies described pediatric patients. Only one study was from a low‐income country and most African regions were not represented. The rates of major and minor complications were 11% and 27%, respectively, while 30‐ and 90‐day mortality rates were 2% and 3% each. Postoperative liver failure (8%), surgical site infections (6%), and bile leaks (6%) were common complications.ConclusionsThis review indicates a dearth of data from LMICs on outcomes after hepatectomy, particularly from African regions and low‐income countries.

show abstract

Major hepatectomies for perihilar cholangiocarcinoma: Predictors for clinically relevant postoperative complications using the International Study Group of Liver Surgery definitions

Cited by 23 publications

References 40 publications

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Curative-intent Surgery for Perihilar Cholangiocarcinoma with and without Portal Vein Resection - A Comparative Analysis of Early and Late Outcomes

Risk factors of postoperative bile leakage after liver resection: A systematic review and meta‐analysis

A Systematic Review and Meta‐Analysis of Oncologic Liver Resections in Low‐ and Middle‐Income Countries: Opportunities to Improve Evidence and Outcomes

Contact Info

Product

Resources

About