Assessment of morbidity and mortality after hepatic resections.

OBJECTIVE

To describe morbidity and mortality in patients undergoing hepatectomy.

METHODS

We evaluated hepatectomy according to type of surgery, perioperative blood transfusion, hospital stay, complications and postoperative mortality. For statistical analysis we used the Ficher's exact test, considering significant p values <0.05.

RESULTS

We performed 22 (31.43%) major hepatectomies, 13 (18.57%) being right hepatectomies extended to segments IVa and IVb, nine (12.86%) left hepatectomies, among these, six included the segment I. We conducted 48 (68.57%) minor hepatectomies, 36 (51.43%) segmental resections and 12 (17.14%) non-anatomical resections. The main indication for resection was colorectal adenocarcinoma metastasis in 27 (38.57%) patients. The higher incidence of primary tumor was hepatocellular carcinoma in 14 (20%) patients, followed by cholangiocarcinoma in six (8.57%). Among the 13 (18.57%) resections for benign diseases, the predominant one was intrahepatic lithiasis (n = 6). Six patients (8.57%) received perioperative blood transfusion. Hospital stay ranged from 2 to 28 days (mean four days). Eight (11.43%) patients developed postoperative complications. Overall mortality was 8.57%, mostly in patients with hepatocellular carcinoma (5.71%).

CONCLUSION

Metastatic colorectal adenocarcinoma was the main indication for surgery and minor hepatectomies were the most common procedures. Despite the low overall incidence of postoperative complications, there was high morbidity and mortality in cirrhotic patients with hepatocellular carcinoma.