Insufficient future liver remnant and preoperative cholangitis predict perioperative outcome in perihilar cholangiocarcinoma
| Autor: | I. Amygdalos, Jan Bednarsch, Isabella Lurje, Georg Lurje, Maximilian Schulze-Hagen, Paul Halm, Ulf P. Neumann, Tom Florian Ulmer, Georg Wiltberger, Pavel Strnad, Zoltan Czigany, Philipp Bruners |
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| Přispěvatelé: | Surgery, RS: FHML non-thematic output |
| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Cholangitis Liver volume 030230 surgery Logistic regression Resection Cholangiocarcinoma 03 medical and health sciences 0302 clinical medicine medicine Hepatectomy Humans In patient Perihilar Cholangiocarcinoma Retrospective Studies Body surface area Hepatology business.industry Liver Neoplasms Gastroenterology Perioperative Surgery Surgical morbidity Treatment Outcome Bile Duct Neoplasms Liver 030220 oncology & carcinogenesis business Klatskin Tumor |
| Zdroj: | HPB, 23(1), 99-108. ELSEVIER SCI LTD |
| ISSN: | 1477-2574 1365-182X |
| Popis: | Background: Major liver resection has evolved as the mainstay of treatment for patients with perihilar cholangiocarcinoma (pCCA). Here we assessed the suitability of preoperative future liver remnant (FLR) measurement to predict perioperative complications, since surgical morbidity and mortality are high compared to other malignancies.Methods: Between 2011 and 2016, 91 patients with pCCA underwent surgery in curative intent at our institution. The associations of surgical complications with FLR and clinico-pathological characteristics were assessed using logistic regression analyses. Different methods of FLR assessment, the calculatedFLR (cFLR; ratio of FLR to total liver volume), standardized FLR (sFLR; ratio of FLR to liver volume estimated by body surface area) and FLR to bodyweight ratio (FLR/BW) were tested for validity.Results: Multivariable analysis identified preoperative cholangitis (Exp(B) = 0.236; p = 0.030) as the single significant predictor of postoperative mortality and cFLR (Exp(B) = 0.009, p = 0.004) as the single significant predictor of major postoperative morbidity (Clavien-Dindo 3b). Based on these findings we designed a futility criterion (cFLR |
| Databáze: | OpenAIRE |
| Externí odkaz: |
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