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Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications

BACKGROUND: As diagnostic techniques advance and surgical outcomes improve, the rate of utilization of liver hemihepatectomy for various indications will continue to increase. OBJECTIVES: To explore the preoperative predictors of liver hemihepatectomy postoperative complications. PATIENTS AND METHOD...

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Autores principales: Alghamdi, Thamer, Abdel-Fattah, Muataz, Zautner, Andreas, Lorf, Thomas
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams And Wilkins 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004640/
https://www.ncbi.nlm.nih.gov/pubmed/24743499
http://dx.doi.org/10.1097/MEG.0000000000000035
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author Alghamdi, Thamer
Abdel-Fattah, Muataz
Zautner, Andreas
Lorf, Thomas
author_facet Alghamdi, Thamer
Abdel-Fattah, Muataz
Zautner, Andreas
Lorf, Thomas
author_sort Alghamdi, Thamer
collection PubMed
description BACKGROUND: As diagnostic techniques advance and surgical outcomes improve, the rate of utilization of liver hemihepatectomy for various indications will continue to increase. OBJECTIVES: To explore the preoperative predictors of liver hemihepatectomy postoperative complications. PATIENTS AND METHODS: This study included retrospective analysis of the clinical data of patients who underwent either liver hemihepatectomy or extended hemihepatectomy at Georg August University Hospital-Goettingen for the period 2002–2012. The outcomes were either postoperative complications or death of the patient (within 3 months from the end of the operation). Modified classification of surgical complications was adopted in the current study. The preoperative model for end-stage liver disease (MELD) score, aspartate aminotransferase, creatinine, international normalized ratio, and bilirubin in addition to the demographic characteristics of the patients and intraoperative blood loss were analyzed as predictive for postliver hemihepatectomy complications. RESULTS: The study included 144 patients who underwent liver hemiheptectomy or extended hemihepatectomy through the study period (2002–2012). Postoperative complications were reported among patients out of 144 (52.1%). The most frequent complications were pleural effusion (26.7%), biliary leakage (21.3%), wound dehiscence (13.3%), ascites, and intra-abdominal abscess (6.7%). Death was reported among six patients of those who developed complications (8%). There were four cases of hepatic cirrhosis (one macroscopic and three microscopic). Two of the microscopic cases had no postoperative complications (grade 1), whereas one case had grade 3a and the macroscopic case had postoperative complication grade 1. Their MELD scores ranged between 6 and 10 preoperatively. The association between preoperative MELD score and development of posthemihepatetomy was statistically significant, P=0.002. Death was reported in six cases, yielding a mortality rate of 4.17%. MELD score preoperatively was the only significant predictor for postoperative complications. CONCLUSION: The rate of complications following hemihepatectomy remains high, with 52.1% of the patients in the current study having at least one complication as all of our patients underwent either hemihepatectomy or extended hemihepatectomy. A 4.17% mortality rate has been reported. A higher preoperative MELD score is the only significant predictor for the development of posthemihepatectomy complications.
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spelling pubmed-40046402014-04-30 Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications Alghamdi, Thamer Abdel-Fattah, Muataz Zautner, Andreas Lorf, Thomas Eur J Gastroenterol Hepatol Original Articles: Hepato-biliary Neoplasia BACKGROUND: As diagnostic techniques advance and surgical outcomes improve, the rate of utilization of liver hemihepatectomy for various indications will continue to increase. OBJECTIVES: To explore the preoperative predictors of liver hemihepatectomy postoperative complications. PATIENTS AND METHODS: This study included retrospective analysis of the clinical data of patients who underwent either liver hemihepatectomy or extended hemihepatectomy at Georg August University Hospital-Goettingen for the period 2002–2012. The outcomes were either postoperative complications or death of the patient (within 3 months from the end of the operation). Modified classification of surgical complications was adopted in the current study. The preoperative model for end-stage liver disease (MELD) score, aspartate aminotransferase, creatinine, international normalized ratio, and bilirubin in addition to the demographic characteristics of the patients and intraoperative blood loss were analyzed as predictive for postliver hemihepatectomy complications. RESULTS: The study included 144 patients who underwent liver hemiheptectomy or extended hemihepatectomy through the study period (2002–2012). Postoperative complications were reported among patients out of 144 (52.1%). The most frequent complications were pleural effusion (26.7%), biliary leakage (21.3%), wound dehiscence (13.3%), ascites, and intra-abdominal abscess (6.7%). Death was reported among six patients of those who developed complications (8%). There were four cases of hepatic cirrhosis (one macroscopic and three microscopic). Two of the microscopic cases had no postoperative complications (grade 1), whereas one case had grade 3a and the macroscopic case had postoperative complication grade 1. Their MELD scores ranged between 6 and 10 preoperatively. The association between preoperative MELD score and development of posthemihepatetomy was statistically significant, P=0.002. Death was reported in six cases, yielding a mortality rate of 4.17%. MELD score preoperatively was the only significant predictor for postoperative complications. CONCLUSION: The rate of complications following hemihepatectomy remains high, with 52.1% of the patients in the current study having at least one complication as all of our patients underwent either hemihepatectomy or extended hemihepatectomy. A 4.17% mortality rate has been reported. A higher preoperative MELD score is the only significant predictor for the development of posthemihepatectomy complications. Lippincott Williams And Wilkins 2014-06 2014-05-01 /pmc/articles/PMC4004640/ /pubmed/24743499 http://dx.doi.org/10.1097/MEG.0000000000000035 Text en © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins http://creativecommons.org/licenses/by-nc-nd/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivitives 3.0 License, where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially.
spellingShingle Original Articles: Hepato-biliary Neoplasia
Alghamdi, Thamer
Abdel-Fattah, Muataz
Zautner, Andreas
Lorf, Thomas
Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title_full Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title_fullStr Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title_full_unstemmed Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title_short Preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
title_sort preoperative model for end-stage liver disease score as a predictor for posthemihepatectomy complications
topic Original Articles: Hepato-biliary Neoplasia
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4004640/
https://www.ncbi.nlm.nih.gov/pubmed/24743499
http://dx.doi.org/10.1097/MEG.0000000000000035
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