Morbidity and mortality associated with liver resections for primary malignancies in children

Nathan P. Zwintscher, Kenneth S. Azarow, John D. Horton

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


Purpose: Liver resection (LR) is a high-risk procedure with limited data in the pediatric surgical literature regarding short-term outcomes. Our aim was to characterize the patient population and short-term outcomes for children undergoing LR for malignancy. Methods: We studied 126 inpatient admissions for children ≤20 years of age undergoing LR in 2009 using the Kids' Inpatient Database. Patients had a principal diagnosis of a primary hepatic malignancy and LR listed as one of the first five procedures. Transplantations were excluded. Complications were defined by ICD-9 codes. High-volume centers performed at least 5 LR. Results: The mean age was 5.83 years. The morbidity and mortality rates were 30.7 and 3.7%, respectively. The most common causes of morbidity were digestive system complications (7.4%), anemia (7.3%), and respiratory complications (3.8%). 43.9% received a blood product transfusion. The average length of stay was 10.04 days. When compared to low-volume centers, high-volume centers increased the likelihood of a complication fourfold (P = 0.011) but had 0% mortality (P = 0.089). Conclusion: LR remains a procedure fraught with multiple complications and a significant mortality rate. Highvolume centers have a fourfold increase in likelihood of complications compared to low-volume centers and may be related to extent of hepatic resection.

Original languageEnglish (US)
Pages (from-to)493-497
Number of pages5
JournalPediatric Surgery International
Issue number5
StatePublished - May 2014


  • Children
  • Complications
  • Hepatic malignancy
  • Liver resection

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery


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