ORIGINAL ARTICLE

Liver resection profile in Prof. dr. R.D. Kandou General Hospital: 1-year experience

Michael Iskandar , Michael Tendean, Toar Deliezer Bram Mambu, Ferdinand Tjandra, Jimmy Panelewen, Celine Martino

Michael Iskandar
General Surgery Resident, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia. Email: Michaeliskandarc@gmail.com

Michael Tendean
Staff of Digestive Surgery Division, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia

Toar Deliezer Bram Mambu
Staff of Digestive Surgery Division, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia

Ferdinand Tjandra
Staff of Digestive Surgery Division, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia

Jimmy Panelewen
Staff of Digestive Surgery Division, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia

Celine Martino
General Surgery Resident, General Surgery Department, Medical Faculty of Universitas Sam Ratulangi, Prof. Dr. R. D. Kandou, Manado, Indonesia
Online First: February 21, 2021 | Cite this Article
Iskandar, M., Tendean, M., Mambu, T., Tjandra, F., Panelewen, J., Martino, C. 2021. Liver resection profile in Prof. dr. R.D. Kandou General Hospital: 1-year experience. Bali Medical Journal 10(1): 47-52. DOI:10.15562/bmj.v10i1.2118


Background: The role of liver surgery is increasing for primary and secondary liver tumors. One of the most feared complications of liver surgery is Post-Hepatectomy Liver Failure (PHLF). The authors would like to present their experience in a year for liver surgery with morbidity and mortality, including PHLF as evaluation parameters.

Methods: This is a prospective study from July 2019-2020 in a single-center, in which patients with pre-existing liver pathology were assigned to receive liver resection. Types and duration of liver resection, duration of Pringle maneuver, and blood loss were measured. PHLF was evaluated using the ISGLS classification, and morbidity was evaluated using Clavien-Dindo and FABIB classification. The energy device used varies from the harmonic scalpel, ligature, and Thulium-doped fiber laser (TDFL). Data were processed descriptively with IBM SPSS 25 (SPSS Inc., Chicago, USA). Data are presented in descriptive frequency tables as medians and means.

Results: A total of 17 procedures were performed, including minor hepatectomies (58.82 %) and major hepatectomies (41.18%). The mean duration of operation 5.3 hours, the duration of parenchymal transection 91.5 minutes, and the estimated blood loss 1638.2 cc. Vascular occlusion method using Pringle maneuver with mean duration of 31.67 minutes. PHLF incidence found were grade B (5.88 %) and grade C (11.7%), while morbidities by Clavien-Dindo mostly are grade 2 (38.2%) and FABIB classification mostly are Bleeding (45%). The mean postoperative ICU is 3.06days, and the mortality rate is as high as 23.52%.

Conclusion: Liver resection in our center is quite fair judging from the low incidence of PHLF, although the mortality rate is at 23.52%. Due to that, surgical technique and teamwork between units involved need to be improved even further.

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