Surgical management of patients with hepatocellular carcinoma who undergo hepatectomy: Emphasis on early discharge after operation

Abstract

During the past decade, considerable efforts have been expended to promote early recovery in patients undergoing hepatic resection. This paper reviews the outcome of surgical therapy in a series of 259 consecutive patients with hepatocellular carcinoma who were managed according to a recently developed protocol that emphasized early resumption of daily activities. Although the hospital mortality and morbidity rates were 4.63% and 46.2%, respectively, about one-half of the patients returned home within 12 postoperative days. The major reasons for prolonged duration of hospital care were intra-abdominal infection and persistent fluid retention in the abdominal and thoracic cavities. The preoperative presence of cardiac, pulmonary, and renal diseases had no effect on mortality or morbidity; however, the presence of diabetic condition was significantly correlated with the occurrence of intra-abdominal infection. Appropriate management of diabetes and efforts to reduce bile leakage are expected to contribute further to improvements in outcome in patients with hepatocellular carcinoma who undergo hepatectomy.