Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean

Table 1 ASA scores for patients undergoing major liver resections in a low volume Caribbean center

Score	ASA descriptor	n (%)
I	Completely healthy	5 (7.3)
II	Mild systemic disease	24 (34.8)
III	Severe systemic disease that is not incapacitating	31 (44.9)
IV	Incapacitating disease that is a threat to life	9 (13)
V	Moribund and not expected to survive > 24 h	0

Table 2 Performance scores for patients undergoing major liver resections in a low volume Caribbean center

Grade	ECOG Performance status	n (%)
0	Fully active, able to carry out all activities without restriction	10 (14.5)
1	Restricted in physically strenuous activity, but ambulatory and able to carry out light work	20 (29)
2	Ambulatory and capable of self care, but unable to carry out work activities. Up and about > 50% of waking hours	33 (47.8)
3	Capable of limited self care and confined to bed or chair for more than 50% of waking hours	5 (7.3)
4	Completely disabled and cannot carry on self care. Confined to bed or chair	1 (1.5)
5	Dead	0

Table 3 Complications after major liver resections in patients undergoing major liver resections in a low volume Caribbean center

Morbidity	Description	n	Percent
Overall	Number of patients with any complication	21/69	30.4%
Minor	Clavien-Dindo I or II	17/69	24.6%
	Pneumonia	2	2.9%
	Deep Vein Thrombosis	2	2.9%
	Surgical site infections	2	2.9%
	Bile leaks	4	5.8%
	ISGLS Grade-B post-hepatic liver failure	7	10.1%
Major	Clavien-Dindo III or IV	11/69	15.9%
	Anastomotic dehiscence	1	1.5%
	Intra-abdominal collection	4	5.8%
	Right hepatic artery injury	1	1.5%
	Strangulated internal hernia	1	1.5%
	ISGLS Grade-C post-hepatic liver failure	4	5.8%
Mortality	30-d mortality: All causes (1) 69 yr-old man: Sepsis after bladder leak after abdomino-perineal resection for synchronous colorectal liver metastases (2) 80 yr-old man: bile leak after extended right hepatectomy for colorectal liver metastases (3) 69 yr-old woman: Post-Hepatic Liver Failure after extended right hepatectomy for hepatocellular carcinoma (4) 79 yr-old man: Anastomotic leak after extended right hepatectomy for hilar cholangiocarcinoma	4/69	5.8%