Outcomes of hepatic resection at St. Luke’s medical center, Philippines: a five-year case series

Abstract

Introduction: More and more Filipinos are being diagnosed with liver diseases, however, it still remains a “silent epidemic”. Liver cancer is relatively common in the Philippines primarily because many Filipinos suffer from liver cirrhosis, which then precedes 80% of all hepatic cancers.The common etiology among Filipinos are chronic hepatitis B and C,smoking,and alcoholism.This aims to evaluate all patients who underwent liver resection for demographics,intra- and post-operative outcomes and describe the 5-year trend in a two-hospital, single-institution.More patients will be aware of different liver pathology and more physicians will be updated on the current hepatic disease status in the Philippines for proper patient selection and best outcomes in hepatic resection. Method: This is a retrospective, descriptive type of study design with time period of 5 years (2014-2018). This includes all patients who underwent hepatectomy.Patients’ records will be collected.Data to be evaluated include patient’s age, gender, type of hepatic mass (primary malignant, metastatic, pre-malignant, benign),intraoperative data (blood loss,operative time, laparoscopic vs open technique, type of hepatic resection), and postoperative data(resection margin,final histopathology) of patients. The primary outcome will be length-of-stay in hospital (LOSH) and operative mortality. Result: From January 2014 to December 2018,108 patients underwent hepatic resection,24 were excluded,84 patients were included.Mean age is 54.50 years(SD17.26),38 were females (45.24%) and 46 were males (54.76%).Blood loss with the mean of 993.27ml(SD 1335.21).Mean operative time was 295.73 minutes(SD125.15).There were 11 cases of laparoscopic liver resections performed(13.10%) and 73 open hepatectomies(86.9%).84 had negative resection margins and 9 had positive resection margins,89.29% and 10.70%.Primary maligant was still most common at 55.95%.The mean hospital stay was 8.68days(SD6.39).No intraoperative mortality was noted. Conclusion: This study described the demographics,intra-and post-operative 5-year data of hepatic resection.Outcomes noted in this study was comparable to international benchmarking for hepatic resections and may serve as a reference for evaluating surgical performance.