Hepatic resection at a community hospital

Hepatic resection remains the "gold standard" in the primary management of primary and metastatic tumors to the liver. Advanced surgical techniques al ong with more modern and sophisticated equipment have led to an increasing number of hepatic resections being performed with a concomitant decrease in morbidity and mortality. We followed prospectively 18 consecutive hepatic resections performed over a period of approximately 2.5 years. The setting was a community teaching hospital with a low volume of referrals for hepati c resection. Sixteen (88%) had metastatic disease and two had primary liver disease. There were four trisegmentectomies, four lobectomies, four segmen tectomies, and six large wedge resections. Average estimated blood loss was 608 mi. Seven patients required transfusions. Complications occurred in fi ve patients (27%). Ln-hospital mortality was 0%. Our experience suggests th at liver resections in a low-volume community hospital can be performed saf ely provided an experienced surgical team with familiarity of advanced surg ical techniques and sophisticated equipment used in hepatic resection is re adily available.