AUDIT OF LIVER RESECTIONS IN ARMY LIVER TRANSPLANT UNIT

Abstract

Objective: To evaluate the types of liver resections performed for various liver diseases and assess the overall outcome in a series of patients presenting to Army Liver Transplant Unit, Pak Emirates Military Hospital.

Study Design: Retrospective observational study.

Place and Duration of Study: This study was carried out in Army Liver Transplant Unit – Pak Emirates Military Hospital Rawalpindi, from Dec 2015 to Dec 2016.

Material and Methods: All patients who underwent any type of liver resection were included by non-probability convenient sampling. History, clinical findings, radiological variables and histological findings were recorded in a proforma based on hospital database. The data was analyzed using SPSS 17.

Results: A total of seventeen patients underwent various forms of liver resections out of which there were thirteen males and four females. The mean age of patients was 40.4 ± 21.4 years. Nearly half of patients had chronic, hepatitis either hepatitis C (35.3%) or chronic hepatitis B (11.8%). Most patients were asymptomatic (42%) and were diagnosed on routine screening by transabdominal ultrasound followed by pain (23%), mass abdomen (17%) and jaundice (12%). The average size of mass was 5.1 x 5.2 cms on CT scan. The most common tumor in adults was hepatocellular cancer (8 cases) whereas hepatoblastoma (3 cases) was common in children. Two resections were performed for giant hemangioma. Non-anatomical resection was performed in 8 cases followed by left lateral segmentectomy (5 cases) and right hemihepatectomy (3 cases) and right extended hepatectomy (1 case). There was bile leak in one case and recurrence in two cases. There was one peroperative mortality because
of massive bleeding.

Conclusion: Liver resections are among one of the complex surgical procedures which can be performed safely in specialized centers. Most commonly resections were performed for malignant diseases in pediatric and adult population but symptomatic benign diseases can also be resected with better outcomes.