Surgical treatment of hepatocellular carcinoma: Evidence-based outcomes

Table 1 The outcome of hepatectomy in major institutions

Author	Criteria	Morbidity (%)	Mortality (%) 5-yr	Survival (%)
Blumgart[22]	Child	45	4.5	39
Bismuth H[7]	Child	40	10.0	48
Belghiti[8]	Child	31	6.4	37
Gozzetti[9]	Child	36	3.5	43
Bruix[10]	Child	-	3.9	51
Fan[6]	ICG15	38	2.5	49
Wu CC[11]	ICG15	11	2.3	51
Makuuchi[7]	ICG15	26	0.0	53

The Child classification is usually used by Western surgeons, while Eastern surgeons rely on the ICG-R15 retention rate to determine the liver function of patients. Operative morbidity rates were similar, but operative mortality rates were lower in the East, and five-year survival rates were higher in the East.

Table 2 The effect of hemihepatic occlusion in hepatectomy with cirrhotic patients (mean ± SE)

	Total inflow occlusion group (n = 28)	Hemihepatic occlusion group (n = 30)	P value
Resected liver weight (g)	443.9 ± 10.7 (150-1670)	422.7 ± 17.4 (180-1320)	0.29
Overall ischemic time (min)	96.0 ±10.9 (62-196)	94.2 ±9.9 (64.5-188)	0.28
Liver transection time (min)	86.4 ± 5.3 (64-171)	84.4 ± 5.2 (62-174.5)	0.54
Area of liver cut surface (cm2)	103.1 ± 8.7 (62-208)	101.2 ± 6.9 (64-204)	0.86
Overall operative blood loss (mL)	6.82 ± 0.32 (3.8-11.5)	6.65 ± 0.26 (3.9-10.8)	0.37
Blood loss during parenchymal transection (mL)	1685 ± 170 (500-4800)	1159 ± 221 (400-4200)	0.049
Blood loss in declamping period (mL)	1015 ± 112 (400-4300)	974 ± 101 (300-4200)	0.51
Need for blood transfusion (n)	379 ± 12 (50-890)	179 ± 18 (50-460)	0.03
	12	5	0.04

Hemihepatic clamping is recommended for complex central liver resections when the area of transaction is wide. Wu et al. Arch Surg. 2002.