Pancreaticobiliary Disease

Hepatectomy

Cleveland Clinic Digestive Disease and Surgery Institute's Liver Tumor Program offers diverse and advanced surgical liver procedures are offered to patients with primary and secondary liver malignancy, as well as with symptomatic or complicated benign liver tumors. Cancers affecting the liver that are treated by our surgical team include hepatocellular carcinoma, cholangiocarcinoma (bile duct cancer), colorectal cancer liver metastases, gallbladder cancer and other conditions. Benign liver tumors that are intervened surgically include large and symptomatic hemangiomas, adenomas and complex cysts. The liver tumor surgical team performs complex operations including extended hepatectomies, staged hepatectomies, associating liver partition with portal vein ligation for staged hepatectomy (ALPPS), and liver transplantation (see Transplantation section for liver transplant outcomes).

The Cleveland Clinic Liver Tumor Program is a multidisciplinary platform comprised by physicians from diverse specialties including liver surgery, hepatology, oncology and interventional radiology. Treatment decision tailored for each individual patient is made through a multidisciplinary liver tumor board.

Partial Hepatectomy ACS NSQIP Outcomes

2019

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) objectively measures and reports risk-adjusted surgical outcomes based on a defined sampling and abstraction methodology. These outcomes data reflect Cleveland Clinic’s overall partial hepatectomy ACS NSQIP performance benchmarked against 140 participating sites.

Partial Hepatectomy (140 Sites)NObservedExpected
30 Day Morbidity898.99%11.65%
Pneumonia891.12%1.12%
Deep Vein Thrombosis (DVT) / Pulmonary Embolus893.37%1.18%
Urinary Tract Infection (UTI)890.00%1.08%
Surgical Site Infection (SSI)894.49%6.36%
Sepsis891.12%3.20%
C.diff Colitis890.00%0.46%
Return to Operating Room (ROR)893.37%1.96%
Readmission896.74%8.47%
Invasive Intervention892.25%5.12%
Bile Leakage893.37%4.39%
Liver Failure891.12%1.13%

American College of Surgeons National Surgical Quality Improvement Program, 2020.
ACS NSQIP® Semiannual Report July 23, 2020, Chicago: American College of Surgeons.

Major Hepatectomy ACS NSQIP Outcomes

2019

The American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP®) objectively measures and reports risk-adjusted surgical outcomes based on a defined sampling and abstraction methodology. These outcomes data reflect Cleveland Clinic’s overall major hepatectomy ACS NSQIP performance benchmarked against 132 participating sites.

Major Hepatectomy (132 Sites)NObservedExpected
30 Day Morbidity4126.83%26.42%
Pneumonia410.00%1.97%
Deep Vein Thrombosis (DVT) / Pulmonary Embolus414.88%4.44%
Renal Failure414.88%3.33%
Sepsis4017.50%9.44%
Readmission4119.51%13.51%
Invasive Intervention4119.51%19.34%
Bile Leakage4112.20%18.10%
Liver Failure414.88%7.36%

American College of Surgeons National Surgical Quality Improvement Program, 2020.
ACS NSQIP® Semiannual Report July 23, 2020, Chicago: American College of Surgeons.