title: A ten-year experience with hepatic resection in 338 patients: evolutions in indications and of operative mortality.
abstract: OBJECTIVE
  To report changes in indications for, and operative mortality of, elective hepatic resection during the 10 year period 1980-1989.
  
  
  METHODS
  Retrospective study.
  
  
  METHODS
  District hospital.
  
  
  METHODS
  338 consecutive patients who underwent elective hepatic resection.
  
  
  METHODS
  During the first five years (1980-1984) 99 resections were done, 10 through a right thoracoabdominal incision, and the hepatic pedicle was clamped in 6. During the period 1985-1989 239 resections were done, only 7 (3%) through a thoracoabdominal incision, and the hepatic pedicle was occluded in 197 (82%).
  
  
  METHODS
  Changes in indications for operation and operative technique, and mortality.
  
  
  RESULTS
  Indications for resection in the first period were: benign lesions (n = 39), primary hepatic cancer (n = 30-15 had hepatocellular carcinoma associated with cirrhosis), and metastatic disease (n = 30). Six patients died, five from uncontrollable bleeding during operation. Indications during the second half were: benign lesions (n = 105, 44%), primary hepatic cancer (n = 87, 36%-62 (29%) had hepatocellular carcinoma associated with cirrhosis), and metastatic disease (n = 47, 20%). There was only 1 death during operation (air embolism), and 9 cirrhotic patients died during the postoperative period.
  
  
  CONCLUSIONS
  More hepatic resections are being done and the indications are changing, with more patients with cancer and benign tumours being operated on; increasing use of pedicle occlusion has resulted in a significant decrease in uncontrollable operative bleeding; and mortality is still related to the presence of associated cirrhosis.
authors.affiliation: Department of Digestive Surgery, Hôpital Beaujon, Clichy-Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Belghiti
authors.forename: I
authors.initials: I
authors.lastname: Di Carlo
authors.forename: A
authors.initials: A
authors.lastname: Sauvanet
authors.forename: M
authors.initials: M
authors.lastname: Uribe
authors.forename: F
authors.initials: F
authors.lastname: Fekete
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D006528:Carcinoma, Hepatocellular / Q000601:surgery; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000379:methods / Q000401:mortality / Q000706:statistics & numerical data; D006801:Humans; D008103:Liver Cirrhosis / Q000601:surgery; D008107:Liver Diseases / Q000401:mortality / Q000601:surgery*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies