Perioperative morbidity in hepatic surgery.
OBJECTIVE
The aim of this study was to identify potentially prognostic factors that could predict the morbidity and mortality of liver resection for metastatic cancer.


METHODS
From January 1990 through December 1999, 136 patients who were treated for liver metastases of all primaries were identified from a prospective database. A stepwise procedure using logistic regression analysis was used to identify prognostic factors.


RESULTS
Postoperative morbidity and mortality were 27% (95% confidence interval: 20-36%) and 2% (95% confidence interval: 0.0-4.0%) respectively. In our series we found the duration of surgery (postoperative complications increasing from 10% for operations of 2 hours or less to 44% for operations of more than 3.5 hours) and perioperative blood transfusion as prognostic factors for postoperative complications in general; we found a specific relation between extended right hemihepatectomy and postoperative bile duct related problems.


CONCLUSIONS
Elective hepatic surgery is safe, irrespective of its extent. The importance of technical measures to prevent blood loss and bile leakage has to be underlined. No perioperative factor could be determined to be exclusionary when considering a patient for resection.
Mutsaerts
Elar
E
Department of Surgery, The Netherlands Cancer Institute/Antoni van Leeuwenhoek ziekenhuis, Amsterdam, The Netherlands.
Zoetmulder
Fan
F
Hart
A
A
van Coevorden
F
F
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002763:Cholecystectomy; D016001:Confidence Intervals; D017707:Erythrocyte Transfusion; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D011183:Postoperative Complications / Q000401:mortality*; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D016019:Survival Analysis; D013997:Time Factors