Pediatric Surgery International

, Volume 30, Issue 5, pp 493–497 | Cite as

Morbidity and mortality associated with liver resections for primary malignancies in children

  • Nathan P. ZwintscherEmail author
  • Kenneth S. Azarow
  • John D. Horton
Original Article



Liver resection (LR) is a high-risk procedure with limited data in the pediatric surgical literature regarding short-term outcomes. Our aim was to characterize the patient population and short-term outcomes for children undergoing LR for malignancy.


We studied 126 inpatient admissions for children ≤20 years of age undergoing LR in 2009 using the Kids′ Inpatient Database. Patients had a principal diagnosis of a primary hepatic malignancy and LR listed as one of the first five procedures. Transplantations were excluded. Complications were defined by ICD-9 codes. High-volume centers performed at least 5 LR.


The mean age was 5.83 years. The morbidity and mortality rates were 30.7 and 3.7 %, respectively. The most common causes of morbidity were digestive system complications (7.4 %), anemia (7.3 %), and respiratory complications (3.8 %). 43.9 % received a blood product transfusion. The average length of stay was 10.04 days. When compared to low-volume centers, high-volume centers increased the likelihood of a complication fourfold (P = 0.011) but had 0 % mortality (P = 0.089).


LR remains a procedure fraught with multiple complications and a significant mortality rate. High-volume centers have a fourfold increase in likelihood of complications compared to low-volume centers and may be related to extent of hepatic resection.


Liver resection Hepatic malignancy Complications Children 


Conflict of interest

No authors have any significant disclosures related to this manuscript or its publication.


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Copyright information

© Springer-Verlag Berlin Heidelberg (outside the USA) 2014

Authors and Affiliations

  • Nathan P. Zwintscher
    • 1
    Email author
  • Kenneth S. Azarow
    • 2
  • John D. Horton
    • 1
  1. 1.Department of SurgeryMadigan Army Medical CenterTacomaUSA
  2. 2.Department of SurgeryOregon Health and Science UniversityPortlandUSA

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