ArticleAnnals of surgery2022
Improved Mortality, Morbidity, and Long-Term Outcome After Anatomical Hepatectomy With the Glissonean Pedicle Approach in Patients With Hepatocellular Carcinoma: 30 Years' Experience at a Single Institute.
Article in Annals of surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers.
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17 citing papers in PubMed, 23 citations in OpenAlex.
- Laparoscopic hepatectomy is feasible for patients diagnosed with hepatocellular carcinoma and cirrhotic liver.World journal of gastrointestinal surgery · 2026Article
- Significant Improvement in Long-Term Survival after Liver Resection for Hepatocellular Carcinoma: Evolving Outcomes over 20 Years.Yonsei medical journal · 2025Article
- Irreversible electroporation combined with checkpoint blockade stimulates antitumor immune response in a hepatocellular carcinoma mouse model.World journal of gastrointestinal oncology · 2025Article
- Review
- Recurrence and survival after robotic vs laparoscopic liver resection in very-early to early-stage (BCLC 0-A) hepatocellular carcinoma.Surgical endoscopy · 2025Observational
- Indications for and limitations of laparoscopic anatomical liver resection: assessment of postoperative complications stratified by complexity of liver resection.Surgical endoscopy · 2025Article
- Association of the Number of Concurrent Metabolic Syndrome Risk Factors with Textbook Outcomes Following Liver Resection for Patients with Hepatocellular Carcinoma: A Multicenter Study.Annals of surgical oncology · 2025Article
- Efficiency and safety of laparoscopic left hemihepatectomy: A study of intrathecalWorld journal of gastrointestinal surgery · 2024Article
- Predictive factors of 90-day mortality after curative hepatic resection for hepatocellular carcinoma: a western single-center observational study.Langenbeck's archives of surgery · 2024Observational
- A multicenter propensity score analysis of significance of hepatic resection type for early-stage hepatocellular carcinoma.Hepatology international · 2024Article
- Laparoscopic left hemihepatectomy guided by indocyanine green fluorescence: A cranial-dorsal approach.World journal of gastrointestinal surgery · 2024Article
- Development of sarcopenia-based nomograms predicting postoperative complications of benign liver diseases undergoing hepatectomy: A multicenter cohort study.Frontiers in nutrition · 2023Article
- Article
- Impact of sarcopenia on outcomes of patients undergoing liver resection for hepatocellular carcinoma.Journal of cachexia, sarcopenia and muscle · 2022Article
- Noninvasively Assessed Portal Hypertension Grade Predicts Post-Hepatectomy Liver Failure in Patients With HepatocellCarcinoma: A Multicenter Study.Frontiers in oncology · 2022Article
- Counterclockwise modular laparoscopic anatomical mesohepatectomy using combined glissonean pedicle (Takasaki approach) and hepatic vein-guided approaches.Frontiers in oncology · 2022Article
- Improvement and development in anatomical hepatectomy for hepatocellular carcinoma.Hepatobiliary surgery and nutrition · 2021Article
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Authors and funding
10 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveWe evaluated the morbidity and mortality after anatomical hepatectomy with the Glissonean pedicle approach, and long-term outcomes in relation to the morbidity in patients with hepatocellular carcinoma (HCC). SUMMARY BACKGROUND DATA: The mortality, morbidity, and long-term outcomes were evaluated retrospectively.
methodsA total of 1953 patients with HCC underwent various anatomical hepatectomies with the Glissonean pedicle approach between 1985 and 2014. The mortality (30-day and 90-day) and morbidity (Clavien-Dindo class Ilia or higher) were evaluated among six 5-year eras (1985-1989, 1990-1994, 1995-1999, 2000-2004, 2005-2009, 2010-2014).
resultsA total of 460 patients (24%) showed morbidity, and the overall 30-day and 90-day mortality rates were 1.8% and 3.3%, respectively. The 30-day (3.9%, 3.0%, 1.8%, 1.3%, 0.3%, 0.5%: P = 0.0074) and 90-day mortality (6.0%, 4.3%, 3.8%, 2.8%, 2.2%, 1.4%: P = 0.0445) significantly improved over the eras. Blood loss >2 L (odds ratio: 11.808, P = 0.0244) was an independent risk factor for 30-day mortality, and blood loss >2 L (odds ratio: 4.046, P = 0.0271) and bile leakage (odds ratio: 2.122, P = 0.0078) were independent risk factors for 90-day mortality on multivariate analysis. Morbidity was significant independent prognostic factors for overall survival (relative risk: 2.129, P < 0.0001) and recurrence-free survival (relative risk: 1.299, P < 0.0001) in patients with HCC.
conclusionsAnatomical hepatectomy with the Glissonean pedicle approach was achieved safely in patients with HCC. For more safety and longer survival, blood loss, bile leakage, and morbidity should be reduced. Longterm outcomes after anatomical hepatectomy with the Glissonean pedicle approach in patients with HCC have been improved over 30 years with gradually less mortality and morbidity due to decreases in blood loss >2 L and bile leakage.
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