ASSESSEMENT OF POSTOPERATIVE COMPLICATION RATE AND ASSOCIATED FACTORS FOLLOWING HEPATECTOMY FOR HEPATOCELLULAR CARCINOMA
Main Article Content
Abstract
Objective: To determine the rate of postoperative complications and associated factors in hepatectomy for hepatocellular carcinoma (HCC).
Materials and Methods: A retrospective cross-sectional study was conducted on 95 patients with HCC who underwent hepatectomy at Binh Dan Hospital from January 2022 to July 2025. Preoperative liver function was assessed using the Child–Pugh classification, ALBI score, and MELD score. Postoperative complications and associated factors were statistically analyzed.
Results: The overall postoperative complication rate was 29.5%. Factors significantly associated with complications included comorbidities (p=0.048), previous hepatectomy (p=0.037), open surgery (p=0.046), operative time >180 minutes (p=0.003), and blood loss ≥500 mL (p=0.002). Higher ALBI and MELD scores showed a trend toward increased risk of complications.
Conclusion: Hepatectomy for HCC demonstrated an acceptable complication rate. Postoperative complications were associated with comorbidities and surgical factors, particularly prolonged operative time and increased blood loss. ALBI and MELD scores may assist in preoperative liver function assessment.
Article Details
Keywords
Hepatectomy, hepatocellular carcinoma, ALBI, postoperative complications.
References
[2] Jarnagin WR, Gonen M, Fong Y, DeMatteo RP, Ben-Porat L, Little S, et al. Improvement in perioperative outcome after hepatic resection: analysis of 1,803 consecutive cases over the past decade. Ann Surg. 2002;236(4):397-407.
[3] Tsilimigras DI, Sahara K, Moris D, Mehta R, Paredes AZ, Bagante F, et al. Trends in postoperative outcomes after hepatic resection: an analysis of 12,000+ patients from a multi-institutional database. J Gastrointest Surg. 2019;23(5):1007-1017.
[4] Li C, Wen TF, Yan LN, Li B, Wang WT, Yang JY, et al. Risk factors associated with postoperative complications after hepatectomy for hepatocellular carcinoma. Hepatogastroenterology. 2011;58(112):2139-2144.
[5] Teh SH, Nagorney DM, Stevens SR, Offord KP, Therneau TM, Plevak DJ, et al. Risk factors for mortality after surgery in patients with cirrhosis. Gastroenterology. 2007;132(4):1261-1269.
[6] Northup PG, Wanamaker RC, Lee VD, Adams RB, Berg CL. Model for End-Stage Liver Disease (MELD) predicts nontransplant surgical mortality in patients with cirrhosis. Ann Surg. 2005;242(2):244-251.
[7] Rahbari NN, Koch M, Mehrabi A, Weitz J, Büchler MW. Repeat hepatectomy for recurrent hepatocellular carcinoma: a multicenter analysis. Ann Surg Oncol. 2011;18(3):650-657.
[8] Johnson PJ, Berhane S, Kagebayashi C, Satomura S, Teng M, Reeves HL, et al. Assessment of liver function in patients with hepatocellular carcinoma: a new evidence-based approach—the ALBI grade. J Clin Oncol. 2015;33(6):550-558.
[9] Hyder O, Pulitano C, Firoozmand A, Dodson R, Wolfgang CL, Choti MA, et al. A risk model to predict postoperative liver failure after major hepatectomy. J Am Coll Surg. 2013;216(4):691-699.
[10] Van den Broek MA, Olde Damink SW, Dejong CH, Lang H, Malagó M, Jalan R, et al. Liver failure after partial hepatic resection: definition, pathophysiology, risk factors and treatment. Ann Surg. 2008;247(5):767-780.