ArticleJournal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract2013
Greater complexity of liver surgery is not associated with an increased incidence of liver-related complications except for bile leak: an experience with 2,628 consecutive resections.
Article in Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 54 papers, 3 of them syntheses that pooled it.
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Who cites it
54 citing papers in PubMed, 3 syntheses or guidelines pooled it, 129 citations in OpenAlex.
- Risk factors of postoperative bile leakage after liver resection: A systematic review and meta-analysis.Cancer medicine · 2023Pooled it
- Haemostatic Efficacy of Topical Agents During Liver Resection: A Network Meta-Analysis of Randomised Trials.World journal of surgery · 2020Pooled it
- Enhanced recovery following liver surgery: a systematic review and meta-analysis.HPB : the official journal of the International Hepato Pancreato Biliary Association · 2014Pooled it
- Incidence, patterns and management of complications (90-day-analysis) after liver surgery - a single center experience with 3177 consecutive hepatic resections.Langenbeck's archives of surgery · 2026Article
- Postoperative course of C-reactive protein level after liver surgery-when to worry?Translational gastroenterology and hepatology · 2026Article
- Intention-to-Treat Analysis of Hepatic Resection for Liver Metastases from Uveal Melanoma: A Single-Center Experience.Annals of surgical oncology · 2025Article
- Incidence and risk factors of biliary leaks after partial hepatectomy within an enhanced recovery perioperative pathway: a single-center retrospective cohort study.Langenbeck's archives of surgery · 2025Article
- Perioperative Morbidity and Mortality Among Elderly and Octogenarian Patients Undergoing Major Abdominal Surgery.Maedica · 2025Article
- [Endoscopic management of complications in the hepatobiliary and pancreatic system and the tracheobronchial tree].Chirurgie (Heidelberg, Germany) · 2023Article
- Post-hepatectomy biliary leaks: analysis of risk factors and development of a simplified predictive scoring system.Langenbeck's archives of surgery · 2023Article
- Failure of enhanced recovery after surgery in liver surgery: a systematic review and meta analysis.Frontiers in medicine · 2023Review
- High volume transplant experience is beneficial but not mandatory for the performance of complex liver resections.Hepatobiliary surgery and nutrition · 2022Article
- Imaging Features of Post Main Hepatectomy Complications: The Radiologist Challenging.Diagnostics (Basel, Switzerland) · 2022Review
- Outcomes of simultaneous laparoscopic, hybrid, and open resection in colorectal cancer with synchronous liver metastases: a propensity score-matched study.Scientific reports · 2022Article
- The Role of the Interventional Radiologist in Bile Leak Diagnosis and Management.Seminars in interventional radiology · 2021Review
- The Impact of Establishing a Dedicated Liver Surgery Program at a University-affiliated Hospital on Workforce, Workload, Surgical Outcomes, and Trainee Surgical Autonomy and Academic Output.Annals of surgery open : perspectives of surgical history, education, and clinical approaches · 2021Article
- Predictive ability of preoperative CT scan for the intraoperative difficulty and postoperative outcomes of laparoscopic liver resection.Surgical endoscopy · 2021Article
- Risk Factors for Complications Requiring Interventional Radiological Treatment After Hepatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
- CBCT-based navigation system for open liver surgery: Accurate guidance toward mobile and deformable targets with a semi-rigid organ approximation and electromagnetic tracking of the liver.Medical physics · 2021Article
- Variation in Drain Management Among Patients Undergoing Major Hepatectomy.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2021Article
Corrections and comments
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
backgroundAdvances in technique, technology, and perioperative care have allowed for the more frequent performance of complex and extended hepatic resections. The purpose of this study was to determine if this increasing complexity has been accompanied by a rise in liver-related complications.
methodsA large prospective single-institution database of patients who underwent hepatic resection was used to identify the incidence of liver-related complications. Liver resections were divided into an early era and a late era with equal number of patients (surgery performed before or after 18 May 2006). Patient characteristics and perioperative factors were compared between the two groups.
resultsBetween 1997 and 2011, 2,628 hepatic resections were performed, with a 90-day morbidity and mortality rate of 37 and 2 %, respectively. We identified higher rates of repeat hepatectomy (12.2 vs 6.1 %; p < 0.001), two-stage resection (4.0 vs 1 %; p < 0.001), extended right hepatectomy (17.6 vs 14.6 %; p = 0.04), and preoperative portal vein embolization (9.1 vs 5.9 %; p < 0.001) in the late era. The incidence of perihepatic abscess (3.7 vs 2.1 %; p = 0.02) and hemorrhage (0.9 vs 0.3 %; p = 0.045) decreased in the late era and the incidence of hepatic insufficiency (3.1 vs 2.6 %; p = 0.41) remained stable. In contrast, the rate of bile leak increased (5.9 vs 3.7 %; p = 0.011). Independent predictors of bile leak included bile duct resection, extended hepatectomy, repeat hepatectomy, en bloc diaphragmatic resection, and intraoperative transfusion.
conclusionsThe complexity of liver surgery has increased over time, with a concomitant increase in bile leak rate. Given the strong association between bile leak and other poor outcomes, the development of novel technical strategies to reduce bile leaks is indicated.
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