title: Liver resection morbidity, mortality, and risk factors at the departments of hepatobiliary surgery in Veracruz, Mexico.
abstract: BACKGROUND
  Liver resection has been associated with high morbidity and mortality, and the most serious complication is liver failure. Patient evaluation is limited to risk scales. The 50-50 criteria and bilirubin peak>7mg/dl have been used as mortality predictors.
  
  
  OBJECTIVE
  The aim of this study was to determine the risk factors associated with morbidity and mortality for liver resection in our population.
  
  
  METHODS
  A retrospective study was carried out on 51 patients that underwent liver resection. Sociodemographic variables, pathology, and the surgical act were analyzed, together with morbidity and mortality and their associated factors.
  
  
  RESULTS
  Fifty-one patients, 23 men and 28 women, were analyzed. They had a mean age of 51.4±19.13 years, 64.7% had concomitant disease, and their mean MELD score was 7.49±1.79. The mean size of the resected lesions was 7.34±3.47cm, 51% were malignant, and 34 minor resections were performed. The Pringle maneuver was used in 64.7% of the cases and the mean blood loss was 1,090±121.76ml. Morbidity of 25.5% was associated with viral hepatitis infection, greater blood loss, transfusion requirement, the Pringle maneuver, lower hemoglobin and PTT values, and higher MELD, INR, bilirubin, and glucose values. A total 3.9% mortality was associated with hyperbilirubinemia, hyperglycemia, and greater blood loss and transfusions.
  
  
  CONCLUSIONS
  The main risk factors associated with the morbidity and mortality of liver resection in our population were those related to the preoperative biochemical parameters of the patient and the factors that occurred during the surgical act.
authors.affiliation: Departamento de Cirugía Hepatobiliar, Unidad Médica de Alta Especialidad, Hospital de Especialidades No 14 Centro Médico Nacional "Adolfo Ruiz Cortinez", Instituto Mexicano del Seguro Social, Veracruz, México; Departamento de Cirugía Hepatobiliar, Hospital de Alta Especialidad de Veracruz, Veracruz, México. Electronic address: gmtzmier@gmail.com.
authors.forename: G
authors.initials: G
authors.lastname: Martínez-Mier
authors.affiliation: Departamento de Cirugía Hepatobiliar, Hospital de Alta Especialidad de Veracruz, Veracruz, México.
authors.forename: S
authors.initials: S
authors.lastname: Esquivel-Torres
authors.affiliation: Departamento de Cirugía Hepatobiliar, Unidad Médica de Alta Especialidad, Hospital de Especialidades No 14 Centro Médico Nacional "Adolfo Ruiz Cortinez", Instituto Mexicano del Seguro Social, Veracruz, México.
authors.forename: R A
authors.initials: RA
authors.lastname: Alvarado-Arenas
authors.affiliation: Departamento de Cirugía Hepatobiliar, Unidad Médica de Alta Especialidad, Hospital de Especialidades No 14 Centro Médico Nacional "Adolfo Ruiz Cortinez", Instituto Mexicano del Seguro Social, Veracruz, México.
authors.forename: A B
authors.initials: AB
authors.lastname: Ortiz-Bayliss
authors.affiliation: Departamento de Investigación, Unidad Médica de Alta Especialidad, Hospital de Especialidades No 14 Centro Médico Nacional "Adolfo Ruiz Cortinez", Instituto Mexicano del Seguro Social, Veracruz, México.
authors.forename: F A
authors.initials: FA
authors.lastname: Lajud-Barquín
authors.affiliation: Departamento de Investigación, Unidad Médica de Alta Especialidad, Hospital de Especialidades No 14 Centro Médico Nacional "Adolfo Ruiz Cortinez", Instituto Mexicano del Seguro Social, Veracruz, México.
authors.forename: S
authors.initials: S
authors.lastname: Zilli-Hernandez
mesh_terms: D000328:Adult; D000368:Aged; D001652:Bile Ducts / Q000601:surgery*; D001663:Bilirubin / Q000097:blood; D013505:Digestive System Surgical Procedures / Q000009:adverse effects* / Q000401:mortality*; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects / Q000401:mortality*; D006801:Humans; D008099:Liver / Q000378:metabolism / Q000601:surgery*; D008297:Male; D008800:Mexico / Q000453:epidemiology; D008875:Middle Aged; D011183:Postoperative Complications; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D001663:Bilirubin
keywords: Cirugía hepática; Factores de riesgo; Liver resections; Liver surgery; Resecciones hepáticas; Risk factors