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Am J Surg. 2010 Nov;200(5):591-5. doi: 10.1016/j.amjsurg.2010.07.014.

Hepatic surgery at a VA tertiary medical center: lessons learned.

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  • 1Department of Surgery, University of California, San Francisco, USA.

Abstract

BACKGROUND:

The development of a hepatic surgery center within a US Department of Veterans Affairs hospital is dependent on proper training and institutional support, which can translate into low operative morbidity and mortality rates.

METHODS:

Patients who underwent hepatic procedures between 2003 and 2009 were retrospectively reviewed. A subset analysis of laparoscopic liver resections for patients with hepatocellular cancer (HCC) was performed. One hundred twenty-six patients underwent 130 hepatic procedures, 65% of which were hepatic resections. Ninety-seven percent of cases were for malignant disease, including HCC (70%).

RESULTS:

The morbidity and mortality rates were 15.5% and 2.4%, respectively. For patients with HCC there was no difference in operative outcomes or overall survival when procedures were performed laparoscopically.

CONCLUSIONS:

A Veterans Affairs (VA) hospital specializing in hepatic surgery can achieve low complication rates comparable with those of high-volume centers. The numbers of patient referrals and hepatic resections and the proportion of laparoscopic operations increased after the creation of a dedicated hepatic surgery center within a single VA hospital.

Published by Elsevier Inc.

PMID:
21056134
[PubMed - indexed for MEDLINE]
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