{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T16:36:40Z","timestamp":1773074200997,"version":"3.50.1"},"reference-count":45,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T00:00:00Z","timestamp":1695686400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>The aim of this study was to analyze the nationwide surgical outcome of a left trisectionectomy (LT) and to identify the perioperative risk factors associated with its morbidity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Cases of LT for hepato\u2010biliary malignancies registered at the Japanese National Clinical Database between 2013 and 2019 were retrospectively reviewed. Statistical analyses were performed to identify the perioperative risk factors associated with a morbidity of Clavien\u2013Dindo classification (CD) \u2265III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Left trisectionectomy was performed on 473 and 238 cases of biliary and nonbiliary cancers, respectively. Morbidity of CD \u2265III and V occurred in 45% and 5% of cases with biliary cancer, respectively, compared with 26% and 2% of cases with nonbiliary cancer, respectively. In multivariable analyses, biliary cancer was significantly associated with a morbidity of CD \u2265III (odds ratio, 1.87; <jats:italic>p<\/jats:italic>\u2009=\u2009.018). In subgroup analyses for biliary cancer, classification of American Society of Anesthesiologists physical status (ASA\u2010PS) 2, portal vein resection (PVR), and intraoperative blood loss \u226530\u2009mL\/kg were significantly associated with a morbidity of CD \u2265III.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Biliary cancer induces severe morbidity after LT. The ASA\u2010PS classification, PVR, and intraoperative blood loss indicate severe morbidity after LT for biliary cancer.<\/jats:p><\/jats:sec>","DOI":"10.1002\/jhbp.1358","type":"journal-article","created":{"date-parts":[[2023,9,26]],"date-time":"2023-09-26T09:16:09Z","timestamp":1695719769000},"page":"1304-1315","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Morbidity after left trisectionectomy for hepato\u2010biliary malignancies: An analysis of the National Clinical Database of Japan"],"prefix":"10.1002","volume":"30","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1562-3265","authenticated-orcid":false,"given":"Fumihiro","family":"Terasaki","sequence":"first","affiliation":[{"name":"Division of Hepato\u2010Biliary\u2010Pancreatic Surgery Shizuoka Cancer Center  Shizuoka 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