A 15-year experience of two hundred and twenty five consecutive right hepatectomies

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• 作者：Giovanni Battista Levi Sandri^a ; ^{gblevisandri@gmail.com} ; Marco Colasanti^a ; Giovanni Vennarecci^a ; Roberto Santoro^a ; Pasquale Lepiane^a ; Gianluca Mascianà ; ^a ; Edoardo de Werra^a ; Roberto Luca Meniconi^a ; Alessandra Campanelli^a ; Andrea Scotti^a ; Mirco Burocchi^a ; Angelo Di Castro^a ; Giampiero D&rsquo ; Offizi^b ; Mario Antonini^c ; Elisa Busi Rizzi^d ; Pasquale Ialongo^e ; Carlo Garufi^f ; Giuseppe Maria Ettorre^a ; ^{gmettorre@scamilloforlanini.rm.it}
• 关键词：Right hepatectomy ; Liver surgery ; Colorectal metastases ; Hepatocellular carcinoma ; Major liver resection
• 刊名：Digestive and Liver Disease
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：49
• 期：1
• 页码：50-56
• 全文大小：481 K
• 卷排序：49

文摘

In case of liver tumor, surgical resection is the therapeutic gold standard to increase patient survival. Among liver resections, right hepatectomy (RH) is defined as a major hepatectomy. The first aim of this study was to analyze the overall morbidity and mortality of patients undergoing RH, the second aim was to assess changes in both patients characteristic and surgical parameters and mortality rates in a single center institution.MaterialsFrom 2001 to December 2015, 225 RH were performed in our center. We analyzed two time period: 2001–2007 and 2008–2015.ResultsNinety days post operative mortality was observed in 9 cases (4%) for the overall cohort. We observed a difference between the two groups in the use of Pringle Maneuver (p < 0,001). This result is consistent in each major surgical indication: HCC (p = 0,001), CLM (p = 0,015) and BT (p = 0,015). The estimated blood losses improved (p = 0,028), particularly for the HCC cases (p = 0,024). No difference was observed in terms of number of transfusions received between the two groups. Reduced length of stay was observed in the second group (p < 0,001), more markedly for CLM cases (p = 0,001).ConclusionTo further improve the outcomes of RH, it is important to performed this major hepatectomy in hepatobiliary centers with an overall liver resection experience of at least few hundred cases.