Influence of biliary and vascular resection types on morbidity in hepatectomies with vascular involvement

• Published in: Journal of surgical oncology
• Main Authors: Silva, Jonatha C F da, Diniz, Alessandro L, Torres, Silvio M, Silva, Dante A, Ribeiro, Héber S D C, de Godoy, André Luiz, de Farias, Igor Correia, Felismino, Tiago Cordeiro, da Costa Junior, Wilson L, Coimbra, Felipe José F
• Format: Journal Article
• Language: English
• Published: United States 05.08.2024
• Subjects: vascular resection; liver neoplasms; hepatectomy; biliary resection; complex surgical oncology
• ISSN: 0022-4790; 1096-9098; 1096-9098
• DOI: 10.1002/jso.27718

Hepatectomies associated with vascular resections pose a technical challenge for surgeons, involving multiple reconstruction techniques. Moreover, adding clinical and surgical risks in the postoperative setting of these complex procedures are mainly due to prolonged surgical periods and potential complications inherent to vascular manipulation. Leveraging the expertise of a Cancer Center, we propose an institutional assessment utilizing the case series from A. C. Camargo Cancer Center in hepatectomies associated with vascular resection, evaluating postoperative complications and outcomes while highlighting clinical, laboratory, pathological, and surgical factors that may influence results. To assess mortality and morbidity associated with hepatectomies involving vascular resection. From a prospective database, a study was performed evaluating postoperative survival and morbidity using scoring systems such as Clavien-Dindo through a cohort analysis. From a total of 1021 liver resections for a period of 10 years, 31 cases were evaluated from a unique cancer center in Brazil! Factors such as the performance of major hepatectomies, the need for blood transfusion, and the administration of neoadjuvant or adjuvant systemic therapy did not appear to influence the outcome of morbidity or mortality. However, the resection of the associated bile duct and the type of vascular resection seemed to influence morbidity outcomes with statistical significance (p = 0.006+ …). Hepatectomies associated with vascular resections are safe in selected cases and when performed in referral centers. Factors such as associated bile duct resection and type of vascular resection should be considered for procedure indication.