title: Postoperative complications of hepatectomy for hepatocellular carcinoma in relation to liver fibrosis.
abstract: OBJECTIVE
  Hepatectomy for hepatocellular carcinoma remains associated with significant morbidity and mortality, despite improved surgical techniques and perioperative management. The relationship between the extent of liver fibrosis and postoperative complications is controversial.
  
  
  METHODS
  We studied 50 patients in whom hepatectomy for Child-Pugh grade A or B had been indicated. Surgical procedures were determined by the indocyanine green retention rate after 15 minutes (ICGR15). The extent of liver fibrosis was graded according to the Desmet classification. The frequency and grade of severity of postoperative complications were evaluated.
  
  
  RESULTS
  Postoperative complications occurred in 24 patients (48%), the frequency being significantly higher among those with liver cirrhosis. However, no significant difference in the incidence of major complications was observed between cirrhotic and non-cirrhotic patients (p=0.311). There was no association between grade of severity of postoperative complications and extent of fibrosis.
  
  
  CONCLUSIONS
  When the surgical indication and procedure were selected based on the Child-Pugh classification and ICGR15 value, respectively, the extent of liver fibrosis did not influence the incidence of major postoperative complications. In particular, there was no significant difference in the incidence of life-threatening postoperative complications between cirrhotic and non-cirrhotic patients.
authors.affiliation: Division of Digestive Surgery, Nihon University School of Medicine, Tokyo, Japan. hnakayam@med.nihon-u.ac.jp
authors.forename: Hisashi
authors.initials: H
authors.lastname: Nakayama
authors.forename: Tadatoshi
authors.initials: T
authors.lastname: Takayama
authors.forename: Akihiro
authors.initials: A
authors.lastname: Hemmi
mesh_terms: D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000150:complications* / Q000601:surgery*; D018450:Disease Progression; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D008103:Liver Cirrhosis / Q000150:complications* / Q000473:pathology; D008113:Liver Neoplasms / Q000150:complications* / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology