Outcomes of liver surgery:A decade of mandatory nationwide auditing in the Netherlands

Background: In 2013, the nationwide Dutch Hepato Biliary Audit (DHBA) was initiated. The aim of this study was to evaluate changes in indications for and outcomes of liver surgery in the last decade. Methods: This nationwide study included all patients who underwent liver surgery for four indications, including colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), and intrahepatic– and perihilar cholangiocarcinoma (iCCA – pCCA) between 2014 and 2022. Trends in postoperative outcomes were evaluated separately for each indication using multilevel multivariable logistic regression a... Mehr ...

Verfasser: de Graaff, Michelle R.
Klaase, Joost M.
Dulk, Marcel den
Buis, C. I.
Derksen, Wouter J.M.
Hagendoorn, Jeroen
Leclercq, Wouter K.G.
Liem, Mike S.L.
Hartgrink, Henk H.
Swijnenburg, Rutger Jan
Vermaas, M.
Belt, Eric J.Th
Bosscha, Koop
Verhoef, Cees
Olde Damink, Steven
Kuhlmann, Koert
Marsman, H. M.
Ayez, Ninos
van Duijvendijk, Peter
van den Boezem, Peter
Manusama, Eric R.
Grünhagen, Dirk J.
Kok, Niels F.M.
Patijn, Gijs A.
Torrenga, Hans
van Heek, N. Tjarda
Oosterling, Steven J.
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: de Graaff , M R , Klaase , J M , Dulk , M D , Buis , C I , Derksen , W J M , Hagendoorn , J , Leclercq , W K G , Liem , M S L , Hartgrink , H H , Swijnenburg , R J , Vermaas , M , Belt , E J T , Bosscha , K , Verhoef , C , Olde Damink , S , Kuhlmann , K , Marsman , H M , Ayez , N , van Duijvendijk , P , van den Boezem , P , Manusama , E R , Grünhagen , D J , Kok , N F M , Dutch Hepato Biliary Audit Group, Collaborators , Patijn , G A , Torrenga , H , van Heek , N T & Oosterling , S J 2024 , ' Outcomes of liver surgery : A decade of mandatory nationwide auditing in the Netherlands ' , European Journal of Surgical Oncology , vol. 50 , no. 6 , 108264 . https://doi.org/10.1016/j.ejso.2024.108264
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-29208802
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://pure.eur.nl/en/publications/4e8d8b0a-c95b-44e6-99e2-1d22d1e796b2

Background: In 2013, the nationwide Dutch Hepato Biliary Audit (DHBA) was initiated. The aim of this study was to evaluate changes in indications for and outcomes of liver surgery in the last decade. Methods: This nationwide study included all patients who underwent liver surgery for four indications, including colorectal liver metastases (CRLM), hepatocellular carcinoma (HCC), and intrahepatic– and perihilar cholangiocarcinoma (iCCA – pCCA) between 2014 and 2022. Trends in postoperative outcomes were evaluated separately for each indication using multilevel multivariable logistic regression analyses. Results: This study included 8057 procedures for CRLM, 838 for HCC, 290 for iCCA, and 300 for pCCA. Over time, these patients had higher risk profiles (more ASA-III patients and more comorbidities). Adjusted mortality decreased over time for CRLM, HCC and iCCA, respectively aOR 0.83, 95%CI 0.75–0.92, P < 0.001; aOR 0.86, 95%CI 0.75–0.99, P = 0.045; aOR 0.40, 95%CI 0.20–0.73, P < 0.001. Failure to rescue (FTR) also decreased for these groups, respectively aOR 0.84, 95%CI 0.76–0.93, P = 0.001; aOR 0.81, 95%CI 0.68–0.97, P = 0.024; aOR 0.29, 95%CI 0.08–0.84, P = 0.021). For iCCA severe complications (aOR 0.65 95%CI 0.43–0.99, P = 0.043) also decreased. No significant outcome differences were observed in pCCA. The number of centres performing liver resections decreased from 26 to 22 between 2014 and 2022, while median annual volumes did not change (40–49, P = 0.66). Conclusion: Over time, postoperative mortality and FTR decreased after liver surgery, despite treating higher-risk patients. The DHBA continues its focus on providing feedback and benchmark results to further enhance outcomes.