Liver surgery in Italy. Criteria to identify the hospital units and the tertiary referral centers entitled to perform it

Guido Torzilli, Luca Viganò, Felice Giuliante, Antonio Daniele Pinna

Research output: Contribution to journalArticle


During the last decades, liver surgery had an extraordinary evolution and diffusion thanks to a drastic reduction of operative mortality and morbidity rates. A debate is ongoing about the need for centralization of liver resections in tertiary referral centers. Robust evidences showed that complex surgical procedures have lower mortality rates when performed in high-volume centers. The present expert group reviewed the literature data and proposed guidelines to identify surgical units that should be entitled to perform liver surgery in Italy. Three separate types of requirements were identified. First, the hospital requirements that include the following criteria: (1) a hospital of 1st level according to the Italian law; (2) the presence of a dedicated hepatobiliary or hepatobiliopancreatic unit or a team dedicated to liver surgery into a general surgery unit; (3) the mandatory presence of oncology, hepatology, radiology, interventional radiology, digestive endoscopy, intensive care, and pathology units; (4) the availability of a liver transplant team into the hospital or into another hospital within an established partnership; (5) a periodic multidisciplinary meeting. Second, the volume requirements: the unit has to perform more than 20 liver resections per year for malignant liver diseases with a 90-day mortality rate 

Original languageEnglish
Pages (from-to)135-142
Number of pages8
JournalUpdates in Surgery
Issue number2
Publication statusPublished - Jun 1 2016



  • Centralization
  • Hospital volume
  • Liver surgery
  • Minimal requirements
  • Mortality and morbidity
  • Multidisciplinary team

ASJC Scopus subject areas

  • Surgery

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