Analysis of the Perioperative Outcomes after Surgical Resection for 145 Patients with Hepatocellular Carcinoma

ABSTRACT

PURPOSE: Surgical resection for the hepatocellular carcinoma (HCC) is the only proven curative treatment modality. Most of these patients have chronic hepatitis with or without cirrhosis; therefore, curative resection with enough of a safety margin is always challenging for hepatic surgeons. The aim of our retrospective study was to analyze the correlation of the complications with the patient factors, the tumor factors and the surgical factors. MATERIALS & METHOD: A total of 145 patients who had hepatocellular carcinoma were resected surgically during the five year and nine months period between September 2000 and June 2006. We collected the database prospectively and we analyzed the perioperative outcomes from the accumulated database. RESULT: Anatomical resection, standard hemihepatectomy or systematic segmentectomy after injection of methylene blue dye into the portal vein branch was performed in 89 patients, and nonanatomical resection was done in 56 patients. The number of major resections that was more than two sections was 72, and the number of minor resection less than two sections was 73. The mean operative time was 270 minutes, the amount of bleeding was 669ml and the mean time of performing the Pringle maneuver was 31.5 minutes. Perioperative complication were noted in 20.0% of the patients and there were five mortalities (3.4%). The only one significant factor that affected a higher complication rate was the ICG15 and the significant factor that affected the mortality rate was the duration of the Pringle maneuver. CONCLUSION: Type oriented hepatic resection that achieves an adequate surgical resection volume is dependent on the status of the tumor and the hepatic reservoir function with limited bleeding, and these factors will help selected patients obtain a very good outcome with an acceptable complication rate and low mortality.