Volume 130, Issue 4 pp. 798-804
RESEARCH ARTICLE

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

Jonatha C. F. da Silva MD

Corresponding Author

Jonatha C. F. da Silva MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

Correspondence Jonatha C. F. da Silva, MD and Felipe José F. Coimbra, MD, MSc, PhD, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211 Liberdade, CEP 01501-900, São Paulo, Brazil.

Email: [email protected] and [email protected]

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Alessandro L. Diniz MD

Alessandro L. Diniz MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Silvio M. Torres MD

Silvio M. Torres MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Dante A. Silva MD

Dante A. Silva MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Héber S. d. C. Ribeiro MD, PhD

Héber S. d. C. Ribeiro MD, PhD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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André Luiz de Godoy MD

André Luiz de Godoy MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Igor Correia de Farias MD

Igor Correia de Farias MD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Tiago Cordeiro Felismino MD

Tiago Cordeiro Felismino MD

Department of Clinical Oncology, A. C. Camargo Cancer Center, São Paulo, Brazil

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Wilson L. da Costa Junior MD, MPH, PhD

Wilson L. da Costa Junior MD, MPH, PhD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

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Felipe José F. Coimbra MD, MSc, PhD

Corresponding Author

Felipe José F. Coimbra MD, MSc, PhD

Department of Abdominal Surgery, A. C. Camargo Cancer Center, São Paulo, Brazil

Correspondence Jonatha C. F. da Silva, MD and Felipe José F. Coimbra, MD, MSc, PhD, A. C. Camargo Cancer Center, Rua Antonio Prudente, 211 Liberdade, CEP 01501-900, São Paulo, Brazil.

Email: [email protected] and [email protected]

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First published: 05 August 2024

Abstract

Introduction

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.

Objective

To assess mortality and morbidity associated with hepatectomies involving vascular resection.

Materials and Methods

From a prospective database, a study was performed evaluating postoperative survival and morbidity using scoring systems such as Clavien−Dindo through a cohort analysis.

Results

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+ …).

Conclusion

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.

CONFLICT OF INTEREST STATEMENT

The authors declare no conflict of interest.

DATA AVAILABILITY STATEMENT

The data that support the findings of this study are available on request from the corresponding author. The data are not publicly available due to privacy or ethical restrictions.

The full text of this article hosted at iucr.org is unavailable due to technical difficulties.