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

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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.

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Author information

Authors and Affiliations

  1. Department of HPB Surgery, Oslo University Hospital at Rikshospitalet, Sognsvannsveien 20, 0372, Oslo, Norway

    Kristoffer Lassen, Kristoffer Watten Brudvik & Åsmund Avdem Fretland

  2. Department of Gastrointestinal Surgery, University Hospital of North Norway, Tromsø, Norway

    Kristoffer Lassen & Linn Såve Nymo

  3. Institute of Clinical Medicine, University of Tromsø, Tromsø, Norway

    Kristoffer Lassen & Linn Såve Nymo

  4. Centre for Clinical Documentation and Evaluation (SKDE), Northern Norway Regional Health Authority, Bodo, Norway

    Frank Olsen

  5. The Intervention Centre, Oslo University Hospital, Oslo, Norway

    Åsmund Avdem Fretland

  6. Institute of Clinical Medicine, University of Oslo, Oslo, Norway

    Åsmund Avdem Fretland

  7. Clinical Surgery, Royal Infirmary of Edinburgh and University of Edinburgh, Edinburgh, UK

    Kjetil Søreide

  8. Department of Clinical Medicine, University of Bergen, Bergen, Norway

    Kjetil Søreide

  9. Department of Gastrointestinal Surgery, Stavanger University Hospital, Stavanger, Norway

    Kjetil Søreide

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  1. Kristoffer Lassen
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Corresponding author

Correspondence to Kristoffer Lassen.

Ethics declarations

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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Lassen, K., Nymo, L.S., Olsen, F. et al. Contemporary practice and short-term outcomes after liver resections in a complete national cohort. Langenbecks Arch Surg 404, 11–19 (2019). https://doi.org/10.1007/s00423-018-1737-3

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  • DOI: https://doi.org/10.1007/s00423-018-1737-3

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