Partiële leverresecties: sterfte, morbiditeit en risicofactoren voor postoperatieve complicaties bij 133 patiënten/137 operaties; Universitair Medisch Centrum Utrecht, 1991/'00

Evaluation of the results of partial liver resections for both benign and malignant abnormalities and the identification of risk factors for the development of complications.

Design

Descriptive, retrospective.

Method

All consecutive partial liver resections performed between January 1991 and October 2000 at the University Medical Centre Utrecht, the Netherlands, were reviewed for preoperative, peroperative and postoperative parameters. Risk factors were determined by means of a univariate analysis and a multiple logistic regression analysis. The 5-year survival rates were calculated using the Kaplan-Meier method.

Results

A total of 133 patients (71 men and 62 women; median age: 58 years (range: 17-79)) underwent 137 hepatic resections for benign (n = 29) and malignant (n = 108) liver abnormalities. In total, 74 procedures (54) were considered to be major hepatic resections and blood transfusion was required in 97 patients (71). A total of 43 complications was observed in 32 patients (32/137; 23). Eight patients died as a result of postoperative complications (8/137; 5.8). Independent risk factors associated with the development of major complications were a major resection (OR: 3.6) and more than 2 peroperative units of packed cells (OR: 5.0). The principal indication for liver resection were colorectal metastases (n = 69). The 5-year survival rate after liver resection for colorectal metastases was 38 (95 CI: range 21-54) with a 5-year disease-free survival rate of 25 (range 10-41). The postoperative mortality in this group was 2.9.

Conclusion

After partial liver resection for benign and malignant lesions the mortality was 5.8 and the morbidity 23. The risk of postoperative morbidity was related to the number of peroperative units of packed cells and the extent of the resection.