Operative mortality after hepatic resection: Are literature-based rates broadly applicable?

Asiyanbola, Bolanle; Chang, David C.; Gleisner, Ana; Nathan, Hari; Makary, Martin; Schulick, Richard D.; Choti, Michael A.; Pawlik, Timothy M.

doi:10.1016/j.jamcollsurg.2007.06.194

Cited by 41 publications

(62 citation statements)

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“…4,5 The overall morbidity and mortality associated with hepatic resection however appears to be under-reported, based on large database reviews. 6 Identification of potentially modifiable factors associated with morbidity and mortality following major liver resection is therefore important.…”

Section: Introductionmentioning

confidence: 99%

“…[7][8][9][10] In cases of major hepatic resection, there is a clear association between mortality and surgical volume when arbitrary cut-offs are used to differentiate high-from a low-volume centers. 6,11,12 There is no consistency or clear reasoning for using certain cut-off thresholds with definitions ranging from 15 to 50 cases per annum used to define a high-volume center. 6,11,12 No previous population studies have examined the association of surgical volume as a continuous variable with inpatient mortality following major hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

“…6,11,12 There is no consistency or clear reasoning for using certain cut-off thresholds with definitions ranging from 15 to 50 cases per annum used to define a high-volume center. 6,11,12 No previous population studies have examined the association of surgical volume as a continuous variable with inpatient mortality following major hepatic resection.…”

Section: Introductionmentioning

confidence: 99%

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The Effect of Surgical Volume and the Provision of Residency and Fellowship Training on Complications of Major Hepatic Resection

Kohn

Nikfarjam

2010

Journal of Gastrointestinal Surgery

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The Effect of Surgical Volume and the Provision of Residency and Fellowship Training on Complications of Major Hepatic Resection

Kohn

Nikfarjam

2010

Journal of Gastrointestinal Surgery

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“…Unfortunately, the incidence of PLF in Germany can hardly be appraised, since there is no register or special code within the disease classification or the reimbursement system. Moreover, negative study results often remain unreported and the available data in literature may underestimate the incidence of PLF [17]. If an overall incidence of 5% is suggested, approximately 750 patients would suffer from PLF in Germany every year.…”

Section: Discussionmentioning

confidence: 99%

“…A recent meta-analysis of van den Broek et al estimated the risk of PLF between 0.7% and 9.1% [14]. However, Asiyanbola et al suggested that actual mortality rates might be even higher due to underreporting of unfavorable study results [17].…”

Section: Introductionmentioning

confidence: 99%

The costs of postoperative liver failure and the economic impact of liver function capacity after extended liver resection—a single-center experience

Lock

Reinhold

Malinowski

et al. 2009

Langenbecks Arch Surg

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Mortality after liver surgery in Germany

Filmann

Walter

Schadde

et al. 2019

British Journal of Surgery

131

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Background: Mortality rates after liver surgery are not well documented in Germany. More than 1000 hospitals offer liver resection, but there is no central regulation of infrastructure requirements or outcome quality.Methods: Hospital mortality rates after liver resection were analysed using the standardized hospital discharge data (Diagnosis-Related Groups, ICD-10 and German operations and procedure key codes) provided by the Research Data Centre of the Federal Statistical Office and Statistical Offices of the Länder in Wiesbaden, Germany.Results: A total of 110 332 liver procedures carried out between 2010 and 2015 were identified. The overall hospital mortality rate for all resections was 5⋅8 per cent. The mortality rate among 17 574 major hepatic procedures was 10⋅4 per cent. Patients who had surgery for colorectal liver metastases (CRLMs) had the lowest mortality rate among those with malignancy (5⋅5 per cent), followed by patients with gallbladder cancer (7⋅1 per cent), hepatocellular carcinoma (9⋅3 per cent) and intrahepatic cholangiocarcinoma (11⋅0 per cent). Patients with extrahepatic cholangiocarcinoma had the highest mortality rate (14⋅6 per cent). The mortality rate for extended hepatectomy was 16⋅2 per cent and the need for a biliodigestive anastomosis increased this to 25⋅5 per cent. Failure to rescue after complications led to mortality rates of more than 30 per cent in some subgroups. There was a significant volume-outcome relationship for CRLM surgery in very high-volume centres (mean 26-60 major resections for CRLMs per year). The mortality rate was 4⋅6 per cent in very high-volume centres compared with 7⋅5 per cent in very low-volume hospitals (odds ratio 0⋅60, 95 per cent c.i. 0⋅42 to 0⋅77; P < 0⋅001).Conclusion: This analysis of outcome data after liver resection in Germany suggests that hospital mortality remains high. There should be more focused research to understand, improve or justify factors leading to this result, and consideration of centralization of liver surgery.

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Operative mortality after hepatic resection: Are literature-based rates broadly applicable?

Cited by 41 publications

References 0 publications

The Effect of Surgical Volume and the Provision of Residency and Fellowship Training on Complications of Major Hepatic Resection

The Effect of Surgical Volume and the Provision of Residency and Fellowship Training on Complications of Major Hepatic Resection

The costs of postoperative liver failure and the economic impact of liver function capacity after extended liver resection—a single-center experience

Mortality after liver surgery in Germany

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