Complex hepatobiliary surgery in the community setting: Is it safe and feasible?

Ronald S. Chamberlain, Zachary W A Klaassen, Prakash R. Paragi

Research output: Contribution to journalArticle

1 Scopus citations

Abstract

Background Complex hepatobiliary surgical procedures for benign and malignant conditions are regularly performed at tertiary academic referral centers with excellent outcomes, but whether similar surgical outcomes are achievable in community hospitals is not well documented. Methods Eighty-four patients underwent complex hepatobiliary surgery between December 2004 and December 2008. Data were prospectively analyzed, including patient demographics, operative procedures, perioperative parameters, pathology, complications up to 30 days postoperatively, and long-term outcomes. Results The most frequent procedures performed were isolated segmentectomy or segmentectomies (n = 41 [49%]). Major hepatic resections (n = 32 [38%]) included 25 lobectomies (30%) and 7 trisegmentectomies (8%). Nine patients (11%) had surgical complications, and the most common indications for surgery was metastatic carcinoma (n = 42 [50%]). Conclusions Complex hepatobiliary surgery can be performed safely at a community-based teaching hospital with excellent outcomes. In the ongoing debate centering on mandatory referral and centralization of complex surgical procedures, tertiary community hospitals with well-determined outcomes should be included.

Original languageEnglish (US)
Pages (from-to)273-280
Number of pages8
JournalAmerican Journal of Surgery
Volume202
Issue number3
DOIs
StatePublished - Sep 1 2011
Externally publishedYes

Keywords

  • Centralization of complex surgical procedures
  • Community hospital
  • Hepatobiliary
  • Liver
  • Malignant neoplasm

ASJC Scopus subject areas

  • Surgery

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