Complications after liver surgery: a benchmark analysis.
Fabio Bagante,Andrea Ruzzenente,Eliza W. Beal,Tommaso Campagnaro,Katiuscha Merath,Simone Conci,Ozgur Akgul,Sorin Alexandrescu,Hugo Marques,Vincent W. T. Lam,Feng Shen,George A. Poultsides,Olivier Soubrane,Guillaume Martel,Calogero Iacono,Alfredo Guglielmi,Timothy M. Pawlik +16 more
TLDR
Risk-adjusted BMVs are likely much more applicable and appropriate in assessing "acceptable" benchmark outcomes following liver surgery as well as other factors influence the risk of complications following hepatectomy.Abstract:
Background The best achievable short-term outcomes after liver surgery have not been identified. Several factors may influence the post-operative course of patients undergoing hepatectomy increasing the risk of post-operative complications. We sought to identify risk-adjusted benchmark values [BMV] for liver surgery. Methods The National Surgery Quality Improvement Program (NSQIP) database was used to develop Bayesian models to estimate risk-adjusted BMVs for overall and liver related (post-hepatectomy liver failure [PHLF], biliary leakage [BL]) complications. A separate international multi-institutional database was used to validate the risk-adjusted BMVs. Results Among the 11,243 patients included in the NSQIP database, the incidence of complications, PHLF, and BL was 36%, 5%, and 8%, respectively. The risk-adjusted BMVs for complication (range, 16–72%), PHLF (range, 1%–20%), and BL (range, 4%–22%) demonstrated a high variability based on patients characteristics. When tested using an international database including nine institutes, the risk-adjusted BMVs for complications ranged from 26% (Institute-4) to 43% (Institute-1), BMVs for PHLF between 3% (Institute-3) and 12% (Institute-5), while BMVs for BL ranged between 5% (Institute-4) and 9% (Institute-7). Conclusions Multiple factors influence the risk of complications following hepatectomy. Risk-adjusted BMVs are likely much more applicable and appropriate in assessing “acceptable” benchmark outcomes following liver surgery.read more
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Risk factors of postoperative bile leakage after liver resection: A systematic review and meta-analysis.
TL;DR: In this article , the authors conducted a meta-analysis to analyze the risk factors for postoperative bile leakage after hepatectomy, and they found that gender, partial hepatactomation, repeat of hepatoctoma, abdominal drain, diabetes, Child≥B, solitary tumor, and chemotherapy are the factors of grade B and C POBL.
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Predictors and Prognostic Significance of Postoperative Complications for Patients with Intrahepatic Cholangiocarcinoma
Yutaka Endo,Zorays Moazzam,Selamawit A. Woldesenbet,Henrique Araújo Lima,Laura Alaimo,M. M. Munir,C. Shaikh,A. Guglielmi,Luca Aldrighetti,M.W. Weiss,Todd W. Bauer,Sorin Alexandrescu,George A. Poultsides,Minoru Kitago,Shishir K. Maithel,Hugo Marques,Guillaume Morel,Carlo Pulitano,Feng Shen,François Cauchy,Bas Groot Koerkamp,Itaru Endo,Timothy M. Pawlik +22 more
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