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Morbidity after left trisectionectomy for hepato-biliary malignancies: An analysis of the National Clinical Database of Japan.
Terasaki, Fumihiro; Hirakawa, Shinya; Tachimori, Hisateru; Sugiura, Teiichi; Nanashima, Atsushi; Komatsu, Shohei; Miyata, Hiroaki; Kakeji, Yoshihiro; Kitagawa, Yuko; Nakamura, Masafumi; Endo, Itaru.
Afiliación
  • Terasaki F; Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
  • Hirakawa S; Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Tachimori H; Endowed Course for Health System Innovation, Keio University School of Medicine, Tokyo, Japan.
  • Sugiura T; Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Nanashima A; Endowed Course for Health System Innovation, Keio University School of Medicine, Tokyo, Japan.
  • Komatsu S; Division of Hepato-Biliary-Pancreatic Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
  • Miyata H; Project Management Subcommittee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
  • Kakeji Y; Project Management Subcommittee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
  • Kitagawa Y; Department of Healthcare Quality Assessment, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.
  • Nakamura M; Department of Health Policy and Management, School of Medicine, Keio University, Tokyo, Japan.
  • Endo I; Database Committee, The Japanese Society of Gastroenterological Surgery, Tokyo, Japan.
J Hepatobiliary Pancreat Sci ; 30(12): 1304-1315, 2023 Dec.
Article en En | MEDLINE | ID: mdl-37750342
BACKGROUND: The aim of this study was to analyze the nationwide surgical outcome of a left trisectionectomy (LT) and to identify the perioperative risk factors associated with its morbidity. METHODS: Cases of LT for hepato-biliary malignancies registered at the Japanese National Clinical Database between 2013 and 2019 were retrospectively reviewed. Statistical analyses were performed to identify the perioperative risk factors associated with a morbidity of Clavien-Dindo classification (CD) ≥III. RESULTS: Left trisectionectomy was performed on 473 and 238 cases of biliary and nonbiliary cancers, respectively. Morbidity of CD ≥III and V occurred in 45% and 5% of cases with biliary cancer, respectively, compared with 26% and 2% of cases with nonbiliary cancer, respectively. In multivariable analyses, biliary cancer was significantly associated with a morbidity of CD ≥III (odds ratio, 1.87; p = .018). In subgroup analyses for biliary cancer, classification of American Society of Anesthesiologists physical status (ASA-PS) 2, portal vein resection (PVR), and intraoperative blood loss ≥30 mL/kg were significantly associated with a morbidity of CD ≥III. CONCLUSIONS: Biliary cancer induces severe morbidity after LT. The ASA-PS classification, PVR, and intraoperative blood loss indicate severe morbidity after LT for biliary cancer.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Sistema Biliar / Pérdida de Sangre Quirúrgica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Revista: J Hepatobiliary Pancreat Sci Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Neoplasias del Sistema Biliar / Pérdida de Sangre Quirúrgica Tipo de estudio: Prognostic_studies / Risk_factors_studies Límite: Humans País/Región como asunto: Asia Idioma: En Revista: J Hepatobiliary Pancreat Sci Año: 2023 Tipo del documento: Article País de afiliación: Japón Pais de publicación: Japón