Operative outcome of liver resections for hepatocellular carcinoma: Retrospective case control study of a twelve-years pioneer experience in the Sudan

Abstract

Introduction: Modern liver surgery in the Sudan started at our institution, The National Ribat University Hospital, in 2002. This study aimed to assess the perioperative events of hepatocellular carcinoma (HCC) resection in our institution during the period January 2002 to December 2013 compared to hepatectomies for benign liver pathologies. Methods: The medical records of 114 patients subjected to hepatectomy were divided into the HCC group (cases), and benign group (controls). The characteristics and perioperative events of both groups were assessed and compared. Results: The mean age of the HCC patients was 58.6 ± 7.7 years. The majority of liver resections in the HCC group were minor (72.7%). The mean intraoperative blood loss was 918.8 ml in the HCC group and 720 ml in benign resections group and the difference between them was not significant, p = 0.129. The mean operative duration of HCC resection was 4 hours. The major postoperative complications were encountered in 16 patients (36.4%) in the HCC group. HCC group thirty-day postoperative mortality was 9.1%, (n = 4 patients) while no patient of the benign group (n = 60) died within that duration, p = .030. Logistic regression multivariate analysis revealed massive bleeding as an independent predictor for major postoperative morbidity, Odds ratio [OR] = 5.899, 95%, Confidence Interval [95% CI], 1.129–30.830, p = .035. Discussion: Our results revealed outcome parameters comparable with the international reports. Conclusion: Further improvements in hepatic surgery in general, and HCC in particular is inevitable. Highlights: