Detailed Abstract
[E-poster - Liver (Liver Disease/Surgery)]
[EP 007] Incidence And Predictive Factors Of Post-hepatectomy Liver Failure, Siriraj Experience
Prawej MAHAWITHITWONG*1 , Sirawit BOONWIWATTANAKAN1 , Yongyut SIRIVATANAUKSORN1 , Somchai LIMSRICHAMRERN1 , Prawat KOSITAMONGKOL1 , Chutwichai TOVIKKAI1 , Wethit DUMRONGGITTIGULE1 , Pholasith SANGSERESTID1 , Charnwit ASSAWASIRISIN1 , Pongpol NIMITPUNYA1
1 Department Of Surgery, Faculty Of Medicine Siriraj Hospital, Mahidol University, THAILAND
Background : Hepatectomy is the standard treatment for either malignant or benign liver disease. Inadequate future liver remnant will lead to post-hepatectomy liver failure (PHLF) that increase morbidity and mortality to the patients, however, the other cause may not well-defined. The aim of this study is to identify incidence and predictive factors of post-hepatectomy liver failure in Siriraj Hospital.
Methods : The medical records of the patients who underwent hepatectomy in Siriraj Hospital between 2018 and 2020 were retrospectively reviewed. The diagnosis and severity of post-hepatectomy liver failure were categorized according to the International Study Group of Liver Surgery criteria.
Results : A total of 419 hepatectomy patients were included. PHLF was developed in 70 patients (16.7%), including grade A 15 (3.6%), grade B 41 (9.8%) and grade C 14 (3.3%). The factors affect PHLF were statistically significant found in patient with preoperative diabetes mellitus (p<0.001), serum albumin level ≤ 3.5 g/dL (p<0.001), major hepatectomy (p<0.001) and intraoperative blood loss > 1 L (p=0.03). Patients in PHLF group have higher mortality than those in non-PHLF group (10.0% vs 1.1%, p=0.001)
Conclusions : PHLF remains a serious complication in patients undergoing hepatectomy that increase mortality. We found that diabetes mellitus, low serum albumin, major hepatectomy and intraoperative blood loss greater than 1 liter were associated with post-hepatectomy liver failure. Consideration with these factors may improve outcome of the surgery.
Methods : The medical records of the patients who underwent hepatectomy in Siriraj Hospital between 2018 and 2020 were retrospectively reviewed. The diagnosis and severity of post-hepatectomy liver failure were categorized according to the International Study Group of Liver Surgery criteria.
Results : A total of 419 hepatectomy patients were included. PHLF was developed in 70 patients (16.7%), including grade A 15 (3.6%), grade B 41 (9.8%) and grade C 14 (3.3%). The factors affect PHLF were statistically significant found in patient with preoperative diabetes mellitus (p<0.001), serum albumin level ≤ 3.5 g/dL (p<0.001), major hepatectomy (p<0.001) and intraoperative blood loss > 1 L (p=0.03). Patients in PHLF group have higher mortality than those in non-PHLF group (10.0% vs 1.1%, p=0.001)
Conclusions : PHLF remains a serious complication in patients undergoing hepatectomy that increase mortality. We found that diabetes mellitus, low serum albumin, major hepatectomy and intraoperative blood loss greater than 1 liter were associated with post-hepatectomy liver failure. Consideration with these factors may improve outcome of the surgery.
SESSION
E-poster
E-Session 03/23 ~ 03/25 ALL DAY