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Contemporary practice and short-term outcomes after liver resections in a complete national cohort

  • Kristoffer Lassen
  • Linn Såve Nymo
  • Frank Olsen
  • Kristoffer Watten Brudvik
  • Åsmund Avdem Fretland
  • Kjetil Søreide
ORIGINAL ARTICLE
  • 11 Downloads

Abstract

Background

Improved outcome after liver resections have been reported in several series, but outcomes from national cohorts are scarce. Our aim was to evaluate nationwide practice and short-term outcomes after liver surgery in a universal healthcare system.

Methods

A complete 5-year cohort of all liver resections from the Norwegian Patient Registry (NPR). Short-term outcomes were aggregated length of stay (a-LoS), reoperation and 90-day mortality.

Results

Of 2118 liver resections, 605 (28.6%) were major, median age was 65 years and 1184 (55%) were male. Most common indication was metastatic disease (n = 1554; 73.4%) and primary malignancy (n = 328; 15.3%). Laparoscopy was performed in 513 (33.9%) of minor and 37 (6.1%) of major liver resections and increased over time to 39.1% of minor resections in 2016. Median a-LoS was 12 days for major resections, 8 days for open minor and 3 days for laparoscopic minor resections. Reoperation was reported for 159 (7.4%) and 90-day mortality for 44 (2.1%). Primary malignancy, male gender, elderly patients and major resections were associated with poorer outcome.

Conclusions

In a national cohort, laparoscopy is used for a substantial proportion of minor resections and was associated with reduced a-LoS. Risk factors for reoperation and mortality were male gender, increased age and major resection for primary malignancy.

Keywords

Liver resection National cohort Short-term outcomes Laparoscopic 

Notes

Compliance with ethical standards

Centre of Clinical Documentation and Evaluation (SKDE) holds a concession from the Norwegian Data Protection Authority to access data from the Norwegian Patient Registry (NPR) for patients treated at Norwegian hospitals in the period 1 January 2012 to 31 December 2016. The Norwegian Data Inspectorate licenced the data registry at SKDE (ref. 15/00271–2/CGN and 16/00289–2/CGN). Further ethical approval was not required according to Norwegian law.

Disclaimer

Data from the Norwegian Patient Register has been used in this publication. The interpretation and reporting of these data are the sole responsibility of the authors, and no endorsement by the Norwegian Patient Register is intended nor should be inferred.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

This article does not contain any studies with human participants or animals performed by any of the authors.

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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of HPB SurgeryOslo University Hospital at RikshospitaletOsloNorway
  2. 2.Department of Gastrointestinal SurgeryUniversity Hospital of North NorwayTromsøNorway
  3. 3.Institute of Clinical MedicineUniversity of TromsøTromsøNorway
  4. 4.Centre for Clinical Documentation and Evaluation (SKDE)Northern Norway Regional Health AuthorityBodoNorway
  5. 5.The Intervention CentreOslo University HospitalOsloNorway
  6. 6.Institute of Clinical MedicineUniversity of OsloOsloNorway
  7. 7.Clinical SurgeryRoyal Infirmary of Edinburgh and University of EdinburghEdinburghUK
  8. 8.Department of Clinical MedicineUniversity of BergenBergenNorway
  9. 9.Department of Gastrointestinal SurgeryStavanger University HospitalStavangerNorway

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