Morbidity after left trisectionectomy for hepato‐biliary malignancies: An analysis of the National Clinical Database of Japan

Abstract

AbstractBackgroundThe aim of this study was to analyze the nationwide surgical outcome of a left trisectionectomy (LT) and to identify the perioperative risk factors associated with its morbidity.MethodsCases of LT for hepato‐biliary malignancies registered at the Japanese National Clinical Database between 2013 and 2019 were retrospectively reviewed. Statistical analyses were performed to identify the perioperative risk factors associated with a morbidity of Clavien–Dindo classification (CD) ≥III.ResultsLeft trisectionectomy was performed on 473 and 238 cases of biliary and nonbiliary cancers, respectively. Morbidity of CD ≥III and V occurred in 45% and 5% of cases with biliary cancer, respectively, compared with 26% and 2% of cases with nonbiliary cancer, respectively. In multivariable analyses, biliary cancer was significantly associated with a morbidity of CD ≥III (odds ratio, 1.87; p = .018). In subgroup analyses for biliary cancer, classification of American Society of Anesthesiologists physical status (ASA‐PS) 2, portal vein resection (PVR), and intraoperative blood loss ≥30 mL/kg were significantly associated with a morbidity of CD ≥III.ConclusionsBiliary cancer induces severe morbidity after LT. The ASA‐PS classification, PVR, and intraoperative blood loss indicate severe morbidity after LT for biliary cancer.