TY - JOUR
T1 - Complex hepatobiliary surgery in the community setting
T2 - Is it safe and feasible?
AU - Chamberlain, Ronald S.
AU - Klaassen, Zachary
AU - Paragi, Prakash R.
PY - 2011/9
Y1 - 2011/9
N2 - 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.
AB - 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.
KW - Centralization of complex surgical procedures
KW - Community hospital
KW - Hepatobiliary
KW - Liver
KW - Malignant neoplasm
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U2 - 10.1016/j.amjsurg.2010.07.042
DO - 10.1016/j.amjsurg.2010.07.042
M3 - Article
C2 - 21871981
AN - SCOPUS:80052178064
SN - 0002-9610
VL - 202
SP - 273
EP - 280
JO - American Journal of Surgery
JF - American Journal of Surgery
IS - 3
ER -