Hospital-Volume and Outcome of Hepatectomy in Chronic Hepatitis Prevalent Area - Insight on Surgical Service for Hepatocellular Carcinoma
Refereed conference paper presented and published in conference proceedings


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AbstractIntroduction: Hospital-volume has been known to be inversely associated with mortality rate in hepatectomy for hepatocellular carcinoma (HCC). In this study, we aim to devise a better strategy to optimize patient outcome after hepatectomy for HCC by evaluating the difference in mortality rate regarding hospital-volume and different pathology. Methods: The public hospitals provide more than 90% of service to the 7 million population of Hong Kong. We performed a retrospective review from the territory-wide surgical audit report on the outcome of major and minor hepatectomy to evaluate the relationship between hospitalvolume and 30-day mortality rate. The 30-day mortality rate of different pathology relating to the hepatectomy was alsoreviewed in one of the centers serving 1.26 million population. Results: The mean annual caseloads of major and minor hepatectomy in public hospitals in Hong Kong were 327 and 482 respectively. 64Ψ of these hospitals had a mean hospital-volume greater than 40 hepatectomy per year, of which at least 12 were major hepatectomy. The overall mortality rates for major hepatectomy and minor hepatectomy were 2.3% and 0.9% respectively. An inverse association between hospital-volume and 30-day mortality was demonstrated in major hepatectomy, but not in minor hepatectomy. The mortality rate of hepatectomy for gallbladder cancer (5.3%) and cholangiocarcinoma (8%) was higher than the mortality rate for HCC (0.3%). Conclusion: Minor hepatectomy for HCC could be performed safely in small-volume hospital. For high risk case requiring major hepatectomy, small-volume hospital should consider networking with highvolume hospital to optimize the surgical outcome. Standardization of case selection criteria and clinical pathway might also help to reduce mortality rate.
All Author(s) ListYue Sun Cheung, Paul Bo San Lai
Name of ConferenceThe 8th Asia-Pacific Primary Liver Cancer Expert Meeting 2017
Start Date of Conference14/07/2017
End Date of Conference16/07/2017
Place of ConferenceSingapore
Country/Region of ConferenceSingapore
Proceedings TitleLiver Cancer 2017
Year2017
Month7
Volume Number6
Issue NumberSuppl 1
Pages66 - 66
LanguagesEnglish-United Kingdom

Last updated on 2020-15-10 at 02:44