Extended hepatectomy has similar perioperative outcomes than other anatomic (2 to 4 segment) liver resections

Introduction: Advances in surgical technique and perioperative care have allowed the performance of extended hepatectomies (EH) with increasing frequency. However, an elevated risk of complications for EH when compared to other liver resections had been described. The aim of this study was to compare post-operative results between EH (5 or mores segments) and 2 to 4 segment hepatectomies. Methods: We conducted retrospective study from December 2000 to May 2015. Demographic and diagnosis variables, post-operative morbidity, mortality and 30-day readmission rate were registered for both procedures. Simple and multivariate statistical analysis was performed. Results: During this period 245 liver resections (more than 1 segment) were performed in our institution, 175 (71,4%) were 2 to 4 segment hepatectomies and 70 (28,6%) were EH. Median age was 56 (range: 17–84) vs. 58 (range: 2–80) yo; Female to male ratio was 53.7% vs. 42.9%; 9.2% vs. 8.6% had Chronic liver disease and 32% vs. 36% had a benign disease respectively. No difference was found in age (p: 0.857), sex (p: 0.157), ASA score (p: 0.496) or diagnosis (p: 0.269) between both groups. In terms of post-operative results, multivariate analysis found no difference in postoperative complications (p: 0.661), mortality (1.7% vs. 2.9% p: 0.972) and 30-day-readmission (p: 0.367) between EH and other anatomic hepatectomies. Conclusions: Extended hepatectomy can be as safe as other anatomic liver resections (2–4 segments) in terms of morbidity, mortality and 30-day-readmission rate in a HPB specialized center.