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01-11-2012 | Original Article

Influence of Hepatic Parenchymal Histology on Outcome Following Right Hepatic Trisectionectomy

Authors: Christopher P. Neal, Christopher D. Mann, Esme Pointen, Angus McGregor, Giuseppe Garcea, Matthew S. Metcalfe, David P. Berry, Ashley R. Dennison

Published in: Journal of Gastrointestinal Surgery | Issue 11/2012

Abstract

Background

Histological abnormalities in the non-tumour-bearing liver (NTBL) may influence outcome following hepatectomy. Effects will be most pertinent following right trisectionectomy but have yet to be specifically examined in this context. This study aimed to investigate the influence of perioperative factors, including NTBL histology, on outcome following right trisectionectomy.

Methods

Pathological review of the NTBL of 103 consecutive patients undergoing right trisectionectomy between January 2003 and December 2009 was performed using established criteria for steatosis, non-alcoholic steatohepatitis (NASH), sinusoidal injury (SI), fibrosis and cholestasis. Perioperative and pathological factors were correlated with post-operative outcome (morbidity, major morbidity, hepatic insufficiency and mortality).

Results

Morbidity, hepatic insufficiency and major morbidity occurred in 37.9 %, 14.6 % and 22.3 % of cases, respectively. Ninety-day mortality rate was 5.8 %. NASH (P = 0.007) and perioperative blood transfusion (P = 0.001) were independently associated with hepatic insufficiency following trisectionectomy. NASH (P = 0.028), perioperative transfusion (P = 0.016), diabetes mellitus (P = 0.047) and coronary artery disease (P = 0.036) were independently associated with major morbidity. Steatosis, SI, fibrosis and cholestasis in the NTBL demonstrated no association with any adverse outcome.

Conclusion

NASH, but not steatosis or SI, is associated with adverse outcome following right trisectionectomy and caution must be exerted when considering major hepatectomy in patients with NASH.

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Title: Influence of Hepatic Parenchymal Histology on Outcome Following Right Hepatic Trisectionectomy
Authors: Christopher P. Neal
Christopher D. Mann
Esme Pointen
Angus McGregor
Giuseppe Garcea
Matthew S. Metcalfe
David P. Berry
Ashley R. Dennison
Publication date: 01-11-2012
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 11/2012
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-012-2008-1

At a glance: The STEP trials

Springer Medicine

Influence of Hepatic Parenchymal Histology on Outcome Following Right Hepatic Trisectionectomy

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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