title: A 15-year experience of two hundred and twenty five consecutive right hepatectomies.
abstract: BACKGROUND
  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.
  
  
  METHODS
  From 2001 to December 2015, 225 RH were performed in our center. We analyzed two time period: 2001-2007 and 2008-2015.
  
  
  RESULTS
  Ninety 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).
  
  
  CONCLUSIONS
  To 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.
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy. Electronic address: gblevisandri@gmail.com.
authors.forename: Giovanni Battista
authors.initials: GB
authors.lastname: Levi Sandri
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Marco
authors.initials: M
authors.lastname: Colasanti
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Giovanni
authors.initials: G
authors.lastname: Vennarecci
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Santoro
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Lepiane
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Mascianà
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Edoardo
authors.initials: E
authors.lastname: de Werra
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Roberto Luca
authors.initials: RL
authors.lastname: Meniconi
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Campanelli
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Scotti
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Mirco
authors.initials: M
authors.lastname: Burocchi
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy.
authors.forename: Angelo
authors.initials: A
authors.lastname: Di Castro
authors.affiliation: Hepatology and Infectious Diseases Unit, National Institute for Infectious Diseases "L. Spallanzani", Rome, Italy.
authors.forename: Giampiero
authors.initials: G
authors.lastname: D'Offizi
authors.affiliation: Anesthesiology and Intensive Care Unit, National Institute for Infectious Disease "L. Spallanzani", Rome, Italy.
authors.forename: Mario
authors.initials: M
authors.lastname: Antonini
authors.affiliation: Diagnostic Imaging Department, National Institute for Infectious Diseases "Lazzaro Spallanzani", Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Busi Rizzi
authors.affiliation: Department of Radiology, Azienda Ospedaliera San Camillo Forlanini, Rome, Italy.
authors.forename: Pasquale
authors.initials: P
authors.lastname: Ialongo
authors.affiliation: Department of Oncology-Ospedale Civile di Pescara, Pescara, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Garufi
authors.affiliation: Division of General Surgery and Liver Transplantation, S. Camillo Hospital, Rome, Lazio, Italy. Electronic address: gmettorre@scamilloforlanini.rm.it.
authors.forename: Giuseppe Maria
authors.initials: GM
authors.lastname: Ettorre
mesh_terms: D000328:Adult; D000368:Aged; D006528:Carcinoma, Hepatocellular / Q000473:pathology / Q000601:surgery*; D015179:Colorectal Neoplasms / Q000556:secondary*; D016208:Databases, Factual; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects* / Q000401:mortality; D006801:Humans; D007558:Italy; D008113:Liver Neoplasms / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology*
keywords: Colorectal metastases; Hepatocellular carcinoma; Liver surgery; Major liver resection; Right hepatectomy