Between May 2000 and November 2006, 213 patients underwent a partial hepatectomy. Of all patients undergoing major liver resection (three or more Couinaud segments), both CT volumetry and HBS were preoperatively performed in 71 patients. Sixteen patients were excluded from the study because of preoperative PVE (n = 15) or partial portal vein thrombosis (n = 1) in the time period between HBS and CT volumetry. Hence, a group of 55 patients was retrospectively analyzed with the approval of our Institutional Review Board with waiver of informed consent. Table 1 summarizes the types of resection performed. Patients with a preoperative suspicion of hilar cholangiocarcinoma underwent an (extended) hemihepatectomy combined with hilar resection and caudate lobe resection. In cholestatic patients, preoperative biliary drainage was performed more than 6 weeks prior to surgery using endoscopic retrograde cholangiopancreatography or percutaneous transhepatic drainage.
5 ). Histopathology of the resection specimen was assessed by an experienced pathologist taking into account features of cholestasis, steatosis, fibrosis, and chronic inflammation.
Postoperative complications were recorded according to the modified classification of surgical complications proposed by Dindo et al.18 (link) In-hospital complications were recorded as well as complications requiring hospital readmission within 3 months related to the operation. Minor complications included grade 1 and grade 2 complications. Major complications were defined as grade 3 and severe complications as grade 4 and grade 5 complications. Liver failure was defined as bilirubin plasma levels >50 µmol/l and/or prothrombin time index <50%,19 (link) elevated plasma ammonia levels combined with signs of hepatic encephalopathy and/or hepatorenal syndrome, requiring intensive care treatment.
Types of Liver Resection with the Corresponding Weight of the Resection Specimen
| procedure | Number of patients | Percentage | Weight resection specimen (g) |
|---|---|---|---|
| Extended right hemihepatectomy | 14 | 25.5 | 975 ± 247 |
| Right hemihepatectomy | 26 | 47.2 | 936 ± 396 |
| Extended left hemihepatectomy | 1 | 1.8 | 443 |
| Left hemihepatectomy | 14 | 25.5 | 348 ± 120 |
| Total | 55 | 100.0 |
Postoperative complications were recorded according to the modified classification of surgical complications proposed by Dindo et al.18 (link) In-hospital complications were recorded as well as complications requiring hospital readmission within 3 months related to the operation. Minor complications included grade 1 and grade 2 complications. Major complications were defined as grade 3 and severe complications as grade 4 and grade 5 complications. Liver failure was defined as bilirubin plasma levels >50 µmol/l and/or prothrombin time index <50%,19 (link) elevated plasma ammonia levels combined with signs of hepatic encephalopathy and/or hepatorenal syndrome, requiring intensive care treatment.
