Postoperative mortality
|
Any reason of death within 90 days after major liver resection. |
Postoperative morbidity
|
|
Posthepatectomy liver failure |
Increasing INR and bilirubin on or after postoperative day 5 plus deviation from regular clinical management (Grade B definition according to the International Study Group of Liver Surgery [ISGLS]) [14]. |
Cholangitis |
Elevation in temperature more than 38.5°C and Leukocytes ≥10*109/L, thought to have a biliary cause, without concomitant evidence of acute cholecystitis, requiring invasive intervention [13]. |
Hepaticojejunostomy (biliary) leakage |
Drainage of fluid with an increased bilirubin level three times greater than the serum level on or after postoperative day three; or the need for interventions as the result of bile collections or biliary peritonitis; or direct visual evidence of defect at anastomoses (definition according to ISGLS) [15]. |
Intra-abdominal abscess formation |
Intra-abdominal fluid collection with positive cultures identified by ultrasonography or computed tomography, associated with persistent fever and elevations of white blood cells [13]. |
Wound infection |
Requiring intervention; otherwise considered as minor complication [13]. |
Portal vein thrombosis |
Conclusive radiologic evidence of thrombosis [13]. |
Hemorrhage |
A drop in haemoglobin level >3 g/dl post-operatively compared with the post-operative baseline level and/or post-operative transfusion of ≥2 units packed red blood cells for a falling haemoglobin and/or the need for radiological intervention (such as embolization) and/or re-laparotomy to stop bleeding (Grade B/C haemorrhage according to ISGLS) [16]. |
Emergency re-laparotomy |
Any (other) reason following major liver resection [13]. |
Pneumonia |
Pulmonary infection with radiological confirmation and requiring antibiotic treatment [13]. |