PERIOPERATIVE PREDICTORS OF MORBIDITY FOLLOWING HEPATIC RESECTION FORNEOPLASM - A MULTIVARIATE-ANALYSIS OF A SINGLE SURGEON EXPERIENCE WITH 105 PATIENTS

Objective Factors that predict mortality or morbidity risk in consecut ive hepatic resections for neoplasm were examined, with controlled var iables of surgical technique and experience. Summary Background Data H epatic resection has become the therapy of choice for the management o f metastatic or primary neoplasms of the liver. Although mortality for this procedure has steadily decreased, associated morbidity remains h igh. Methods One hundred five patients undergoing hepatic resection fo r malignancy over a 4-year period by a single surgeon to identify preo perative, intraoperative, or postoperative predictors of morbid outcom es were studied. Variables were analyzed using multiple regression in a stepwise, logistic model. Results Sixty-day hospital mortality was 2 .8%, with morbidity occurring in 33%. A significant preoperative predi ctor of morbidity was serum bilirubin (p > 0.005). Notably, preoperati ve renal function, or medical illness, did not increase morbid risk. O perative variables increasing risk included extent of resection, blood loss, and operative time (p > 0.005). Conclusions Complex hepatic res ection can be performed with low mortality, and serum bilirubin is the single most powerful predictor of postoperative complication.