An account of liver-related clinical data maintained in a single hepatopancreaticobiliary surgical unit using a cost-free user-friendly database management solution.

Abstract

Introduction\nMaintaining robust clinical data in a low-income country is a challenge due to the lack of electronic medical record systems in state sector hospitals. To mitigate this, the author created a cloud-based cost-free app for the HPB unit of Colombo South Teaching Hospital.\n\n\nMethods\nAnalyzable data variables pertaining to HPB patients were prospectively gathered over a period of 25 months using the app. The app s on-the-go analysis section was used to extract liver-related data.\n\n\nResults\n36% (n = 566) of the HPB data were liver-related. 66% were males. Mean-age was 65. 75% of liver lesions were malignancies; 57% (n = 242) HCC, 16% (n = 66) colorectal liver metastasis (CRLM), 5% (n = 21) non-colorectal liver metastasis (NCRLM). 45% of HCC belonged to 61 to 70 age group. Male:female of HCC 4.8:1, CRLM 1.2:1, and NCRLM 0.9:1. 51% of HCC were solitary-lesions, 30% multiple-lesions. 25% of CRLM were solitary-lesions, 43% multiple-lesions. 53% of HCC were confined to right-lobe, 31% to left-lobe. CRLM 58% in right-lobe, 37% in both lobes. 64% of HCC were discrete-HCC, 30% were diffuse-HCC. Of those with conclusive decisions, 38% (n = 130) of liver-lesions surgically, and 62% (n = 214) non-surgically were managed. Lesions were resectable in 31% of HCC, 74% of CRLM, and 80% of NCRLM. 43% (n = 12) of resectable-HCC underwent hemihepatectomy, 36% (n = 10) NALR, 11% trisectionectomy. For CRLM, this was 60% (n = 15) NALR, 36% (n = 9) hemihepatectomy. 54% (n = 58) of inoperable-HCC had locoregional-therapy; 19%-ablation (72%-thermal, 28%-chemical) and 81%-TACE. 46% of inoperable-HCC were palliated.\n\n\nConclusions\nThis form of mobile-based clinical data maintenance has improved the data completion rates and accuracy of HPB data.