Impact of the COVID-19 pandemic on the short-term outcomes after advanced liver resections performed in institutions certificated by Japanese Society of Hepato-Biliary-Pancreatic Surgery: Results from the Japanese National Clinical Database, 2018-2022.

Purpose: This study aimed to investigate the effects of the coronavirus disease 2019 pandemic on morbidity and mortality after advanced hepatectomy by surgical volume in Japan.

Methods: Data from patients who underwent advanced hepatectomy between 2018 and 2022 from the Japanese National Clinical Database were collected. The transition of the number of hepatectomies and changes in risk-adjusted mortality and major complication rates based on the type of institutions certified by the Japan Society of Hepato-Biliary-Pancreatic Surgery were investigated.

Results: A total of 33 454 cases were included. The number of advanced hepatectomies gradually decreased, whereas the proportion of hepatectomies performed in certified institutions increased (from 63.4% in 2018 to 71.3% in 2022). Although the major complication rate in institution A was higher than that in institution B or noncertified institutions (16.3% vs. 14.5% vs. 13.5%), the in-hospital mortality rate was consistently favorable in the order of institution A, institution B, and noncertified institutions (1.4% vs. 2.0% vs. 2.8%). The monthly standardized mortality and major complication ratios did not significantly increase mostly throughout the pandemic, regardless of the institution type.

Conclusions: The centralization to certified institutions progressed even during the pandemic. Surgical safety after advanced hepatectomy was satisfactorily maintained in any institution.