Liver Surgery Outcomes: Early Experience of a Highly Trained Group in a Low-Income Country

Abstract

Background: The aim of this study is to analyze the morbidity and mortaslity rates among patients undergoing hepatic resections at a tertiary healthcare center in the city of Cuenca, Ecuador. A surgical team with formal training in hepatopancreatobiliary (HPB) surgery performs these surgeries. Study Design: A retrospective descriptive cross-sectional study was performed over time between 2017 and 2022 at the Hospital Jose Carrasco Arteaga, in which all patients who underwent liver resection during a 5-year period were included. The variables used were: I. Demographic data variables (age, sex, BMI, cirrhotic, ASA), II. pre-surgical diagnosis variables, III. Intraoperative and postoperative outcome variables (complications, blood loss, time in the operating room, etc.). Outcomes: A total of 38 liver resections were identified, of which 26.3% were male and 73.7% were female. Mean age: 60.5 years. Of the patients, 31.6% were reoperated, 23.7% were readmitted to the hospital, and 18.4% required a trans-operative blood transfusion. The surgical time averaged 290 minutes. The most common reason for surgery was hepatocarcinoma (23.68%), followed by intrahepatic cholangiocarcinoma (ICC) (13.15%). Morbidity was 23,68%, corresponding to Clavien Dindo 3B or higher. The 90-day mortality rate was 5.25%. Conclusions: According to the results obtained during the period from 2017 to 2022 at Hospital Jose Carrasco Arteaga, the implementation of hepatic resections has been demonstrated to be a safe and effective procedure, characterized by low rates of mortality and morbidity