Table 2.
Intra- and postoperative parameters, including postoperative morbidity and mortality in patients with or without post-hepatectomy liver failure with post-hepatectomy liver failure defined according to the International Study Group of Liver Surgery or according to the ‘50-50 criteria’ by Balzan et al.
| All patients | PHLF according to ISGLS | PHLF according to ‘50–50 criteria’ | ||||||
|---|---|---|---|---|---|---|---|---|
| n = 799 | ISGLS 0 n = 581 | ISGLS A n = 115 | ISGLS B/C n = 103 | P *,† | No PHLF n = 763 | PHLF n = 36 | P † | |
| Intraoperative factors | ||||||||
| Portal vein occlusion | 102 (13) | 58 (10) | 18 (16) | 26 (25) | <0.001 | 92 (12) | 10 (28) | 0.006 |
| Extent of liver resection | ||||||||
| Right hemihepatectomy | 428 (54) | 308 (53) | 68 (59) | 52 (50) | <0.001 | 409 (54) | 19 (53) | 0.005 |
| Right trisectionectomy | 172 (21) | 105 (18) | 23 (20) | 44 (43) | 157 (21) | 15 (42) | ||
| Left hemihepatectomy | 135 (17) | 116 (20) | 15 (13) | 4 (4) | 133 (17) | 2 (6) | ||
| Left trisectionectomy | 64 (8) | 52 (9) | 9 (8) | 3 (3) | 64 (8) | 0 | ||
| Pringle manoeuvre | 69 (9) | 48 (8) | 5 (4) | 16 (16) | 0.011 | 61 (8) | 8 (22) | 0.003 |
| Prolonged operating time (>240 min) | 491 (63) | 339 (59) | 66 (59) | 86 (87) | <0.001 | 460 (61) | 31 (89) | 0.001 |
| Operating time (min), median (range) | 270 (85–792) | 260 (95–735) | 263 (85–592) | 337 (145–792) | <0.001‡ | 268 (85–735) | 383 (145–792) | <0.001‡ |
| Multivisceral resection | 50 (6) | 35 (6) | 5 (4) | 10 (10) | 0.239 | 47 (6) | 3 (8) | 0.487 |
| Perioperative blood transfusion | 251 (31) | 168 (29) | 26 (23) | 57 (55) | <0.001 | 232 (30) | 19 (53) | 0.005 |
| Postoperative outcomes | ||||||||
| Admitted to ICU within (24 h) | 27 (3) | 9 (2) | 2 (2) | 16 (16) | <0.001 | 17 (2) | 10 (28) | <0.001 |
| Post-hepatectomy haemorrhage§ | 62 (8) | 29 (5) | 8 (7) | 25 (24) | <0.001 | 53 (7) | 9 (25) | 0.001 |
| Post-hepatectomy bile leakage | 173 (22) | 115 (20) | 26 (23) | 32 (31) | 0.037 | 161 (21) | 12 (33) | 0.082 |
| Morbidity/mortality | ||||||||
| Postoperative complications | ||||||||
| None | 25 (3) | 17 (3) | 8 (7) | 0 | <0.001 | 25 (3) | 0 | <0.001 |
| Minor complications¶ | 456 (59) | 374 (66) | 58 (51) | 24 (23) | 448 (60) | 8 (22) | ||
| Major complications# | 299 (38) | 173 (31) | 47 (42) | 79 (77) | 271 (37) | 28 (78) | ||
| Postoperative 90-day mortality | 38 (5) | 11 (2) | 5 (4) | 22 (21) | <0.001 | 27 (4) | 11 (31) | <0.001 |
Values are n (%) unless otherwise indicated.
P value refers to a comparison between all three groups.
Categorical variables were compared using the chi-squared test or Fisher’s exact test as appropriate. Continuous variables were compared using the Wilcoxon rank sum test (two-group comparison) or Kruskal–Wallis equality-of-populations rank test (three-group comparison).
Wilcoxon rank sum test or Kruskal–Wallis equality-of-populations rank test.
Definition and grading by the ISGLS.
Minor complications only defined as Clavien–Dindo grade I–II within 90 days after surgery.
Major complications defined as Clavien–Dindo grade III–V within 90 days after surgery. PHLF, post-hepatectomy liver failure; ISGLS, International Study Group of Liver Surgery; ICU, intensive care unit.