Zero mortality in more than 300 hepatic resections

Validity of preoperative volumetric analysis

shinji itoh, Ken Shirabe, Akinobu Taketomi, Kazutoyo Morita, Norifumi Harimoto, Eiji Tsujita, Keishi Sugimachi, Yo Ichi Yamashita, Tomonobu Gion, Yoshihiko Maehara

Research output: Contribution to journalReview article

24 Citations (Scopus)

Abstract

Purpose We reviewed a series of patients who underwent hepatic resection at our institution, to investigate the risk factors for postoperative complications after hepatic resection of liver tumors and for procurement of living donor liver transplantation (LDLT) grafts. Methods Between April 2004 and August 2007, we performed 304 hepatic resections for liver tumors or to procure grafts for LDLT. Preoperative volumetric analysis was done using 3-dimensional computed tomography (3D-CT) prior to major hepatic resection. We compared the clinicopathological factors between patients with and without postoperative complications. Results There was no operative mortality. According to the 3D-CT volumetry, the mean error ratio between the actual and the estimated remnant liver volume was 13.4%. Postoperative complications developed in 96 (31.6%) patients. According to logistic regression analysis, histological liver cirrhosis and intraoperative blood loss >850 mL were significant risk factors of postoperative complications after hepatic resection. Conclusions Meticulous preoperative evaluation based on volumetric analysis, together with sophisticated surgical techniques, achieved zero mortality and minimized intraoperative blood loss, which was classified as one of the most significant predictors of postoperative complications after major hepatic resection.

Original languageEnglish
Pages (from-to)435-440
Number of pages6
JournalSurgery Today
Volume42
Issue number5
DOIs
Publication statusPublished - May 1 2012

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Mortality
Liver
Living Donors
Liver Transplantation
Tomography
Transplants
Liver Cirrhosis
Neoplasms
Logistic Models
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Surgery

Cite this

itoh, S., Shirabe, K., Taketomi, A., Morita, K., Harimoto, N., Tsujita, E., ... Maehara, Y. (2012). Zero mortality in more than 300 hepatic resections: Validity of preoperative volumetric analysis. Surgery Today, 42(5), 435-440. https://doi.org/10.1007/s00595-011-0108-2

Zero mortality in more than 300 hepatic resections : Validity of preoperative volumetric analysis. / itoh, shinji; Shirabe, Ken; Taketomi, Akinobu; Morita, Kazutoyo; Harimoto, Norifumi; Tsujita, Eiji; Sugimachi, Keishi; Yamashita, Yo Ichi; Gion, Tomonobu; Maehara, Yoshihiko.

In: Surgery Today, Vol. 42, No. 5, 01.05.2012, p. 435-440.

Research output: Contribution to journalReview article

itoh, S, Shirabe, K, Taketomi, A, Morita, K, Harimoto, N, Tsujita, E, Sugimachi, K, Yamashita, YI, Gion, T & Maehara, Y 2012, 'Zero mortality in more than 300 hepatic resections: Validity of preoperative volumetric analysis', Surgery Today, vol. 42, no. 5, pp. 435-440. https://doi.org/10.1007/s00595-011-0108-2
itoh, shinji ; Shirabe, Ken ; Taketomi, Akinobu ; Morita, Kazutoyo ; Harimoto, Norifumi ; Tsujita, Eiji ; Sugimachi, Keishi ; Yamashita, Yo Ichi ; Gion, Tomonobu ; Maehara, Yoshihiko. / Zero mortality in more than 300 hepatic resections : Validity of preoperative volumetric analysis. In: Surgery Today. 2012 ; Vol. 42, No. 5. pp. 435-440.
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N2 - Purpose We reviewed a series of patients who underwent hepatic resection at our institution, to investigate the risk factors for postoperative complications after hepatic resection of liver tumors and for procurement of living donor liver transplantation (LDLT) grafts. Methods Between April 2004 and August 2007, we performed 304 hepatic resections for liver tumors or to procure grafts for LDLT. Preoperative volumetric analysis was done using 3-dimensional computed tomography (3D-CT) prior to major hepatic resection. We compared the clinicopathological factors between patients with and without postoperative complications. Results There was no operative mortality. According to the 3D-CT volumetry, the mean error ratio between the actual and the estimated remnant liver volume was 13.4%. Postoperative complications developed in 96 (31.6%) patients. According to logistic regression analysis, histological liver cirrhosis and intraoperative blood loss >850 mL were significant risk factors of postoperative complications after hepatic resection. Conclusions Meticulous preoperative evaluation based on volumetric analysis, together with sophisticated surgical techniques, achieved zero mortality and minimized intraoperative blood loss, which was classified as one of the most significant predictors of postoperative complications after major hepatic resection.

AB - Purpose We reviewed a series of patients who underwent hepatic resection at our institution, to investigate the risk factors for postoperative complications after hepatic resection of liver tumors and for procurement of living donor liver transplantation (LDLT) grafts. Methods Between April 2004 and August 2007, we performed 304 hepatic resections for liver tumors or to procure grafts for LDLT. Preoperative volumetric analysis was done using 3-dimensional computed tomography (3D-CT) prior to major hepatic resection. We compared the clinicopathological factors between patients with and without postoperative complications. Results There was no operative mortality. According to the 3D-CT volumetry, the mean error ratio between the actual and the estimated remnant liver volume was 13.4%. Postoperative complications developed in 96 (31.6%) patients. According to logistic regression analysis, histological liver cirrhosis and intraoperative blood loss >850 mL were significant risk factors of postoperative complications after hepatic resection. Conclusions Meticulous preoperative evaluation based on volumetric analysis, together with sophisticated surgical techniques, achieved zero mortality and minimized intraoperative blood loss, which was classified as one of the most significant predictors of postoperative complications after major hepatic resection.

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