A. Pontallier, C. Laurent, E. Buscail, F. Muscari, J. Adam, L. Chiche, S. Dabernat, V. Vendrely
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引用次数: 0
Abstract
Background and objectives: After hepatic resection, liver failure is not diagnosed until the postoperative
day-5. The aim was to identify a biomarker predictive of severe morbidity, the day after major hepatectomy.
Methods: This retrospective study included patients undergoing major hepatectomy for colorectal
metastases, plasma hepatic marker concentrations being determined at postoperative day-one. Outcomes
were 30-day severe morbidity (Dindo III to V) and grade C post-hepatectomy liver failure.
Results: A total of 433 patients were included. Thirty-day severe morbidity, 90-day mortality and grade-C
post-hepatectomy liver failure rates were 15.5%, 2.5% and 2.5% respectively. Using cut-offs determined
by receiver operating characteristic curves the association of serum bilirubin ? 2.1 mg/dL (? 2 N) and
aspartate-amino-transferase ? 450 IU/L (? 10 N) was selected for the best biochemical predictors of severe
morbidity (sensitivity 38%, specificity 94%) and post-hepatectomy failure (sensitivity 100%, specificity
91%). In multivariate analysis, this score was independently associated with severe morbidity (HR = 5.98,
95% IC 2.65-13.89; P < 0.0001)
Conclusions: The association of plasma bilirubin ? 2.1 mg/dL and aspartate-amino-transferase ? 450 IU/L
is identified as a relevant predictor of severe morbidity and post-hepatectomy failure as early as the first
postoperative day after major hepatectomy for colorectal metastases.
期刊介绍:
International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.