Table 4.
Baseline characteristics and postoperative outcome of the 134 patients who underwent HBS as part of the preoperative work-up (and no preoperative PVE) and the 55 patients who underwent major liver resection before implementation of HBS in our routine
| After implementation of HBS, (n = 134) | Before implementation of HBS, (n = 55) | p= | |
|---|---|---|---|
| Patient characteristics | |||
| Age in years, median (IQR 25–75) | 63.0 (54.0–71.0) | 62.4 (53.3–67.9) | 0.553 |
| Male sex, n (%) | 74 (55.2) | 26 (47.3) | 0.340 |
| ASA classification, n (%) | 0.188 | ||
| Grade I | 34 (25.4) | 8 (14.5) | |
| Grade II | 72 (53.7) | 37 (67.3) | |
| Grade III | 28 (20.9) | 10 (18.2) | |
| Type of resection, n (%) | 0.055 | ||
| Right hemihepatectomy | 53 (39.6) | 26 (47.3) | |
| Left hemihepatectomy | 56 (41.8) | 14 (25.5) | |
| Extended right hemihepatectomy | 15 (11.2) | 14 (25.5) | |
| Extended left hemihepatectomy | 5 (3.7) | 1 (1.8) | |
| Central resection | 2 (1.5) | 0 | |
| Segmentectomy of ≥3 segments | 3 (2.2) | 0 | |
| Type of tumor, n (%) | 0.392 | ||
| PHC | 64 (47.8) | 19 (34.5) | |
| Hepatic metastases | 33 (24.6) | 14 (25.5) | |
| Benign tumor | 17 (12.7) | 13 (23.6) | |
| HCC | 11 (8.2) | 6 (10.9) | |
| Intrahepatic cholangiocarcinoma | 3 (2.2) | 3 (5.5) | |
| Gallbladder carcinoma | 2 (1.5) | ||
| Other, malignant tumors | 4 (3.0) | ||
| FRL measurements | |||
| FRL-volume, % (IQR 25–75) | 53.9 (37.4–73.5) | 41.7 (35.3–61.6) | 0.028 |
| FRL-function, %/min/m2 (IQR 25–75) | 5.00 (3.49–7.10) | 3.94 (2.69–4.85) | 0.005 |
| Standardized FRL-volume, % (IQR 25–75) | 57.2 (41.6–79.7) | 46.4 (36.3–73.3) | 0.120 |
| FRL-BWR, (IQR 25–75) ≥0.5% weight, n (%) |
1.25 (0.89–1.72) 133 (93.3) |
0.99 (0.79–1.57) 55 (100) |
0.120 1.000 |
| Postoperative outcome | |||
| Clinically relevant complicationsa, n (%) | 53 (39.6) | 28 (50.9) | 0.195 |
| Postoperative liver failureb, n (%) | 2 (1.5) | 9 (16.4) | <0.001 |
| Mortality due to liver failure, n (%) | 1 (0.7) | 8 (14.5) | <0.001 |
PVE, portal vein embolization.
a
Complications grade ≥3a according to Clavien-Dindo classifications.
b
Grade C liver failure according to the definition of International Study Group of Liver Surgery; ASA-classification, physical status classification according to American Society of Anaesthesiologists; PHC, perihilar cholangiocarcinoma; HCC, hepatocellular carcinoma; FRL-volume, percentage FRL of the total liver volume; FRL-BWR, future remnant liver/body weight ratio; IQR, interquartile range.