Table 2.
Perioperative outcomes by study period*
| Early | Middle | Late | p value† | p value† | ||
|---|---|---|---|---|---|---|
| Characteristic | Total | (1998–2003) | (2004–2009) | (2010–2015) | (among 3 groups) | (middle vs. late) |
| n | 3707 | 794 (21) | 1402 (38) | 1511 (41) | - | - |
| PVE performed | 312 (8) | 41 (5) | 132 (9) | 139 (9) | 0.001 | 0.8 |
| Hepatic resection | ||||||
| Two-stage hepatectomy completed | 112 (3) | 0 | 47 (3) | 65 (4) | < 0.0001 | 0.2 |
| Repeat resection for intrahepatic recurrence | 320 (9) | 46 (6) | 115 (8) | 159 (11) | <0.0001 | 0.03 |
| Major hepatic resection (≥ 3 segments)‡ | 931 (25) | 158 (20) | 316 (23) | 457 (30) | < 0.0001 | < 0.0001 |
| With RFA | 493 (13) | 223 (28) | 159 (11) | 111 (7) | < 0.0001 | < 0.0001 |
| With biliary reconstruction | 183 (5) | 40 (5) | 79 (6) | 64 (4) | 0.2 | 0.09 |
| Operative time, median (range), minutes | 195 (20–1336) | 180 (33–878) | 175 (25–1336) | 225 (20–929) | < 0.0001§ | < 0.0001# |
| Blood loss, median (range), mL | 200 (0–12500) | 300 (10–6800) | 250 (0–7000) | 200 (0–12500) | < 0.0001§ | < 0.0001# |
| Intraoperative red blood cell transfusion administered | 426 (12) | 153 (19) | 204 (15) | 69 (5) | < 0.0001 | < 0.0001 |
| Postoperative complication | 1471 (40) | 304 (38) | 624 (45) | 543 (36) | < 0.0001 | < 0.0001 |
| Comprehensive complication index ≥ 26.2¶ | 697 (19) | 155 (20) | 306 (22) | 236 (16) | < 0.0001 | < 0.0001 |
| ≥ grade IIIa** | 491 (13) | 125 (16) | 209 (15) | 157 (10) | < 0.0001 | < 0.0001 |
| Organ space surgical site infection requiring percutaneous drainage | 303 (8) | 63 (8) | 140 (10) | 100 (7) | 0.004 | 0.001 |
| Postoperative bile leakage ≥ grade B‡‡ | 157 (4) | 31 (4) | 78 (6) | 48 (3) | 0.005 | 0.002 |
| Postoperative hepatic insufficiency§§ | 137 (4) | 53 (7) | 63 (5) | 21 (1) | < 0.0001 | < 0.0001 |
| Length of hospital stay, median (range), days## | 6 (0–73) | 7 (2–73) | 7 (1–72) | 6 (0–63) | < 0.0001§ | < 0.0001# |
| Unplanned readmission within 45 days | 354 (10) | 75 (9) | 142 (10) | 137 (9) | 0.6 | 0.3 |
| 90-day mortality | 81 (2) | 25 (3) | 36 (3) | 20 (1) | 0.008 | 0.02 |
*
Values in table are number of patients (percentage) unless indicated otherwise
†
χ2 test unless indicated otherwise
‡
According to the Brisbane 2000 nomenclature
§
Kruskal-Wallis test
#
Mann-Whitney U test
**
According to the Dindo-Clavien classification
¶
According to the definition by Slankamenac et al.
‡‡
According to the International Study Group of Liver Surgery definition
§§
According to the definition by Mullen et al.
##
Calculated between the operation and the day of discharge
PVE, portal vein embolization; RFA, radiofrequency ablation