Results of Hepatic Resections at S. N. U. H.: A Ten-year Experience

Abstract

The medical records of 399 patients who underwent hepatic resection between January 1981 and December 1990 were reviewed. Information regarding the results of hepatic resection in terms of operative indication, operative procedure, operative morbidity and mortality, was abstracted. Until the end of 1990, a total of 402 hepatic resections were completed including 319 primary malignancies, 4 secondary malignancies, 2 gallbladder carcinomas, 42 intrahepatic cholelithiasis, 35 benign masses. Major hepatic resections were performed on 117 patients(29%). Of the 117 patients, 60(51%) had histologically proven liver cirrhosis. Minor hepatic resections were performed on 285 patients (71%). Sepsis was the most frequent complication, manifested primarily as wound infection(71 cases) or intra-abdominal infection(25 cases). Nonfatal hepatic failure occured in 9 patients with cirrhosis and 1 patient without cirrhosis. There were 38 operative deaths among 402 hepatic resections, for an overall operative mortality of 9.4 %. Twenty five of these patients died from hepatic failure after operation, accounting for 66 % of the total operative mortality. There has been an increasing frequency of hepatic resection during the last five years. Indications for resection increased from 87 to 195 resections for hepatocellular carcinoma. The cumulative data show a decrease in the complication rate and operative mortality. In the recent period, nonlethal postoperative complications have occured in 135 of 286 patients (47%). The overall survival rates in 172 patients with hepatocellular carcinoma excluding operative mortalities and palliative resections and reresections, were 71.0 %, 39.8%, 28.3% for 1, 3, and 5 years, respectively.