Interventions: Liver resections without biliary anastomoses.Main Outcomes Measures: Bile leakage incidence and its correlation to preoperative and intraoperative patient characteristics. Results: Postoperative bile leakage occurred in 22 (3.6%) of 610 patients. Univariate analysis showed that cirrhosis (P=.05) or intraoperative use of fibrin glue (P=.01) PROCEDURAL DETAILS Preoperative diagnostic workup did not routinely include imaging of the biliary tree, which was performed only in the presence See Invited Critique at end of article

Major hepatectomies can be safely performed at the same time as colorectal surgery in selected patients with synchronous metastases with similar short-term results, even in the presence of rectal cancer.

Portal hypertension should not be considered an absolute contraindication to hepatectomy in cirrhotic patients. Child-Pugh A patients with portal hypertension have short- and long-term results similar to patients with normal portal pressure.

Hepatectomy can be considered safe when FRL is >26.5% in patients with healthy liver and >31% in patients with impaired liver function.

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