• Elijah Dixon, Oliver F Bathe, Andrew McKay, Isabelle You, Scot Dowden, David Sadler, Kelly W Burak, J Gregory McKinnon, Walter Miller, and Francis R Sutherland.
• Department of Oncology, University of Calgary, Tom Baker Cancer Centre, Calgary, Alta. elijah.dixon@calgaryhealthregion.ca
• Can J Surg. 2009 Feb 1; 52 (1): 12-7.

BackgroundHigher hospital and surgeon volumes have been associated with improved outcomes following hepatic resection; however, there appear to be additional factors that also play a role. The objective of our study was to examine the outcomes following hepatic resection over the past 13 years in a large urban Canadian health region.MethodsWe used administrative procedure codes to identify all patients from 1991/92 to 2003/04 who underwent a hepatic resection in the Calgary health region, which has a referral base of about 1.5 million people. The primary outcome was operative mortality, defined as death before discharge.ResultsThere were 424 hepatic resections performed in the stated time period. Annual volume was stable until 2000, when it increased substantially. This corresponded to the formation of a multidisciplinary group that provided care to these patients. There were 25 deaths over the study period for a mean mortality of 5.9%. The mean length of stay in hospital was 14.6 (median 10) days. Over time, however, mortality steadily decreased. This corresponded to a concomitant increase in the volume of hepatic resections performed.ConclusionOver the past 13 years, the number of hepatic resections performed has increased; there has been a corresponding improvement in mortality rates. The improved rates are likely the result of multiple factors.

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