Retrospective Cohort Study
Copyright ©The Author(s) 2019. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Feb 27, 2019; 11(2): 199-207
Published online Feb 27, 2019. doi: 10.4254/wjh.v11.i2.199
Clinical outcomes after major hepatectomy are acceptable in low-volume centers in the Caribbean
Shamir O Cawich, Ravi Maharaj, Vijay Naraynsingh, Neil Pearce, Wesley Francis, Kimon O Bonadie, Dexter A Thomas
Shamir O Cawich, Ravi Maharaj, Vijay Naraynsingh, Dexter A Thomas, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine, Trinidad and Tobago 999183, West Indies
Neil Pearce, Department of Surgery, University Hospital Southampton NHS Trust, Southampton, SO16DP, United Kingdom
Wesley Francis, Department Surgery, University of the West Indies, Nassau 999154, Bahamas
Kimon O Bonadie, Department Surgery, Cayman Islands Health Service Authority, Grand Cayman, KY11100, West Indies
Author contributions: Cawich SO designed the study; Cawich SO, Maharaj R, Naraynsingh V, Pearce NW, Francis W, Bonadie KO and Thomas DA performed the research; Pearce NW, Francis W, Bonadie KO and Thomas DA analyzed the data; Cawich SO, Maharaj R, Naraynsingh V and Pearce NW wrote the paper; and Cawich SO, Maharaj R, Naraynsingh V, Pearce NW, Francis W, Bonadie KO and Thomas DA revised the manuscript for final submission.
Institutional review board statement: This research was approved by the Institutional Review Board at the University of the West Indies (IRB CEC/689/08/18).
Informed consent statement: All involved persons (subjects or legally authorized representative) gave their written informed consent prior to study inclusion. Identifying data has been anonymized but is available to the editor in chief upon request.
Conflict-of-interest statement: The authors declare that there are no financial relationships, personal relationships or other scenarios that may represent potential conflicts of interest.
STROBE statement: The authors have read the CONSORT 2010 Statement. The manuscript adheres to the CONSORT 2010 policies, with the exceptions that this is not a randomized trial.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Shamir O Cawich, MBBS, Professor, Department of Clinical Surgical Sciences, University of the West Indies, St. Augustine Campus, St Augustine, Trinidad and Tobago 999183, West Indies. socawich@hotmail.com
Telephone: +1-868-6229909
Received: September 8, 2018
Peer-review started: September 10, 2018
First decision: October 5, 2018
Revised: November 5, 2018
Accepted: January 28, 2019
Article in press: January 28, 2019
Published online: February 27, 2019
Processing time: 171 Days and 6.7 Hours
Core Tip

Core tip: Although there has been a global trend to concentrate major liver resections in tertiary referral centers, it is not practical in the Caribbean region. However, the hepatobiliary centers in the Caribbean do not meet the criteria to be defined as high-volume centers. This study prospectively evaluated outcomes after 69 consecutive major liver resections in a Caribbean center that only performed 13.8 resections per year. With a major morbidity rate of 15.9% and mortality rate of 5.8%, we have shown that the clinical outcomes after major liver resections are acceptable in the established, low-volume hepatobiliary centers in the Eastern Caribbean.