A standard definition of major hepatectomy: resection of four or more liver segments.

Journal Article (Journal Article)

BACKGROUND: While commonly used to describe liver resections at risk for post-operative complications, no standard definition of 'major hepatectomy' exists. The objective of the present retrospective study is to specify the extent of hepatic resection that should describe a major hepatectomy. METHODS: Demographics, diagnoses, surgical treatments and outcomes from patients who underwent a liver resection at two high-volume centres were reviewed. RESULTS: From 2002 to 2009, 1670 patients underwent a hepatic resection. Post-operative mortality and severe, overall and hepatic-related morbidity occurred in 4.4%, 29.7%, 41.6% and 19.3% of all patients. Mortality (7.4% vs. 2.7% vs. 2.6%) and severe (36.7% vs. 24.7% vs. 24.1%), overall (49.3% vs. 40.6% vs. 35.9%) and hepatic-related (25.6% vs. 16.4% vs. 15.2%) morbidity were more common after resection of four or more liver segments compared with after three or after two or fewer segments (all P < 0.001). There were no significant differences in any post-operative outcome after resection of three and two or fewer segments (all P > 0.05). On multivariable analysis, resection of four or more liver segments was independently associated with post-operative mortality and severe, overall, and hepatic-related morbidity (all P < 0.01). CONCLUSIONS: A major hepatectomy should be defined as resection of four or more liver segments.

Full Text

Duke Authors

Cited Authors

  • Reddy, SK; Barbas, AS; Turley, RS; Steel, JL; Tsung, A; Marsh, JW; Geller, DA; Clary, BM

Published Date

  • July 2011

Published In

Volume / Issue

  • 13 / 7

Start / End Page

  • 494 - 502

PubMed ID

  • 21689233

Pubmed Central ID

  • PMC3133716

Electronic International Standard Serial Number (EISSN)

  • 1477-2574

Digital Object Identifier (DOI)

  • 10.1111/j.1477-2574.2011.00330.x


  • eng

Conference Location

  • England