1.1. Introduction
A major hepatectomy is defined as the resection of at least three liver segments. Most often carried out as part of the treatment of a malignant liver tumor, it still causes significant morbidity and mortality.
1.2. Objective
To report the morbidity and survival of patients who underwent major hepatectomy in the hepatobiliary surgery unit of the Ten- gandogo University Hospital Center.
1.3. Methods
A retrospective study was conducted over 83 months. Data of in- terest including patient epidemiology, diagnostics, type of surgery, postoperative outcomes and prognostic factors were studied.
1.4. Results
Major hepatectomies were carried out in 38 patients, 27 of whom were male. There was an annual average of 4.75 major hepatec- tomies, representing 64.4% of liver resections performed. Major hepatectomy was performed in 28 patients (73.6%) for hepato- cellular carcinoma. With respect to laterality, the procedure was a right hepatectomy in 30 patients (79%). Complications were noted in 36.8% of cases. Overall survival was 39.4% with a mean survival time of 19.2 months. Ten patients (26.3%) died within 90 days. The factors influencing survival were tumor size ≥ 15 cm (p = 0.0023), operating time ≥ five hours (p = 0.0011), a Child-Pugh B score (p = 0.0113) and AFP ≥ 200 ng/ml (p= 0.0206). Conclu- sion: Due to delays to diagnosis, major hepatectomy is relatively common in Burkina Faso. Improving diagnostic tools and algo- rithms, strengthening the technical platform and training surgical
teams could help improve patient outcomes. Major hepatectomy remains a challenge, which resource-limited countries can perform provided there is rigorous selection and postoperative monitoring of patients.

Liver Resection; Hepatocarcinoma; Complication; Survival; Burkina Faso