Evidence map›Paper›PMID 30820269›Full record

ArticleWorld journal of hepatology2019

Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean.

Shamir O Cawich, Ravi Maharaj, Vijay Naraynsingh, Neil Pearce, Wesley Francis, Kimon O Bonadie, Dexter A Thomas

Open access · diamondAbstract read
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Article in World journal of hepatology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
1.0field-weighted citation impact, top 26% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 9 citations in OpenAlex.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 3 institutions in 3 countries.

Shamir O CawichDepartment of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago 999183, West Indies. socawich@hotmail.com.
Ravi MaharajDepartment of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago 999183, West Indies.
Vijay NaraynsinghDepartment of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago 999183, West Indies.
Neil PearceDepartment of Surgery, University Hospital Southampton NHS Trust, Southampton, SO16DP, United Kingdom.
Wesley FrancisDepartment Surgery, University of the West Indies, Nassau 999154, Bahamas.
Kimon O BonadieDepartment Surgery, Cayman Islands Health Service Authority, Grand Cayman, KY11100, West Indies.
Dexter A ThomasDepartment of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago 999183, West Indies.
University Hospital Southampton NHS Foundation Trust · GBUniversity of the West Indies · TTUniversity of the West Indies · BS

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundMajor hepatectomies are routinely performed because they are often the only curative treatment for metastatic liver disease. There has been a trend to concentrate major hepatectomies in referral hospitals that perform these operations at high volumes. These high volume referral centers are usually located in developed countries, but many patients in developing nations are not able to access these centers because of financial limitations, lack of social support and/or travel restrictions. Therefore, local hospitals are often the only options many of these patients have for surgical treatment of metastatic liver disease. This is the situation in many Caribbean countries.

aimTo determine the clinical outcomes after major liver resections in a low-resource hepatobiliary center in the Caribbean.

methodsWe prospectively studied all patients who underwent major liver resections over five years. The following data were extracted: patient demographics, diagnoses, ECOG status, operation performed, post-operative morbidity and mortality. Statistical analyses were performed using SPSS ver 16.0.

resultsThere were 69 major liver resections performed by two teams at a mean case volume of 13.8 major resections/year. Sixty-nine major hepatic resections were performed for: colorectal liver metastases 40 (58%), non-colorectal metastases 9 (13%), hepatocellular carcinoma 8 (11.6%), ruptured adenomas 4 (5.8%), hilar cholangiocarcinomas 4 (5.8%), hemangiomata 2 (2.9%), trauma 1 (1.5%) and hepatoblastoma 1 (1.5%). Twenty-one patients had at least one complication, for an overall morbidity rate of 30.4%. There were minor complications in 17 (24.6%) patients, major complications in 11 (15.9%) patients and 4 (5.8%) deaths.

conclusionThere are unique geographic, political and financial limitations to healthcare delivery in the Caribbean. Nevertheless, clinical outcomes are acceptable in the established, low-volume hepatobiliary centers in the Eastern Caribbean.

Indexed as

CaribbeanLiverOutcomesResectionSurgeryVolume

Identifiers

PMID30820269
PMCPMC6393710
OpenAlexW2915313563

What OpenQuestion holds

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.