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Stratification of major hepatectomies according to their outcome: Analysis of 2,212 consecutive open resections in patients without cirrhosis

Annals of Surgery Oct 19, 2020

Viganò L, Torzilli G, Aldrighetti L, et al. - Given that major hepatectomies (MajHs) include a wide range of procedures, researchers sought to classify MajHs according to their outcomes. They evaluated 2,212 patients who underwent hepatectomy in 17 high-volume centers. The reference standards were right hepatectomies (RHs). Relative to RH, mortality, severe morbidity, and liver failure rates were all lower in correlation with left hepatectomy; similar outcomes (other than higher bile leak rate) were reported in correlation with left hepatectomy+Sg1 and mesohepatectomy+/−Sg1. Slightly worse outcomes were observed in correlation with RH + Sg1 vs RH. Higher mortality and liver failure rates were observed with right and left trisectionectomies vs RH, while severe morbidity and bile leak rates were even higher in correlation with left trisectionectomy. Overall, findings suggest that resections included under the term “major hepatectomy” have heterogeneous outcome and it is possible to stratify different MajHs according to their mortality, severe morbidity, liver failure, and bile leak rates.

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