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Article: Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

TitlePosthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)
Authors
Issue Date2011
PublisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surg
Citation
Surgery, 2011, v. 149 n. 5, p. 713-724 How to Cite?
AbstractBackground: Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods: A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results: No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose defining posthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal limits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion: The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery. © 2011 Mosby, Inc.
Persistent Identifierhttp://hdl.handle.net/10722/135545
ISSN
2015 Impact Factor: 3.309
2015 SCImago Journal Rankings: 1.620
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorRahbari, NNen_HK
dc.contributor.authorGarden, OJen_HK
dc.contributor.authorPadbury, Ren_HK
dc.contributor.authorBrookeSmith, Men_HK
dc.contributor.authorCrawford, Men_HK
dc.contributor.authorAdam, Ren_HK
dc.contributor.authorKoch, Men_HK
dc.contributor.authorMakuuchi, Men_HK
dc.contributor.authorDematteo, RPen_HK
dc.contributor.authorChristophi, Cen_HK
dc.contributor.authorBanting, Sen_HK
dc.contributor.authorUsatoff, Ven_HK
dc.contributor.authorNagino, Men_HK
dc.contributor.authorMaddern, Gen_HK
dc.contributor.authorHugh, TJen_HK
dc.contributor.authorVauthey, JNen_HK
dc.contributor.authorGreig, Pen_HK
dc.contributor.authorRees, Men_HK
dc.contributor.authorYokoyama, Yen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorNimura, Yen_HK
dc.contributor.authorFigueras, Jen_HK
dc.contributor.authorCapussotti, Len_HK
dc.contributor.authorBüchler, MWen_HK
dc.contributor.authorWeitz, Jen_HK
dc.date.accessioned2011-07-27T01:36:51Z-
dc.date.available2011-07-27T01:36:51Z-
dc.date.issued2011en_HK
dc.identifier.citationSurgery, 2011, v. 149 n. 5, p. 713-724en_HK
dc.identifier.issn0039-6060en_HK
dc.identifier.urihttp://hdl.handle.net/10722/135545-
dc.description.abstractBackground: Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods: A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results: No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose defining posthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal limits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion: The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery. © 2011 Mosby, Inc.en_HK
dc.languageengen_US
dc.publisherMosby, Inc. The Journal's web site is located at http://www.elsevier.com/locate/surgen_HK
dc.relation.ispartofSurgeryen_HK
dc.subject.meshHepatectomy-
dc.subject.meshLiver - surgery-
dc.subject.meshLiver Failure - classification - diagnosis - physiopathology-
dc.subject.meshPostoperative Complications-
dc.subject.meshSeverity of Illness Index-
dc.titlePosthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)en_HK
dc.typeArticleen_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/j.surg.2010.10.001en_HK
dc.identifier.pmid21236455-
dc.identifier.scopuseid_2-s2.0-79954634037en_HK
dc.identifier.hkuros187676en_US
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-79954634037&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume149en_HK
dc.identifier.issue5en_HK
dc.identifier.spage713en_HK
dc.identifier.epage724en_HK
dc.identifier.isiWOS:000289930700015-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridRahbari, NN=21834967000en_HK
dc.identifier.scopusauthoridGarden, OJ=7006432342en_HK
dc.identifier.scopusauthoridPadbury, R=6603924012en_HK
dc.identifier.scopusauthoridBrookeSmith, M=6505945819en_HK
dc.identifier.scopusauthoridCrawford, M=7402706739en_HK
dc.identifier.scopusauthoridAdam, R=7202478918en_HK
dc.identifier.scopusauthoridKoch, M=7401817256en_HK
dc.identifier.scopusauthoridMakuuchi, M=36050194500en_HK
dc.identifier.scopusauthoridDematteo, RP=7006076369en_HK
dc.identifier.scopusauthoridChristophi, C=7003908136en_HK
dc.identifier.scopusauthoridBanting, S=6602131475en_HK
dc.identifier.scopusauthoridUsatoff, V=36731616800en_HK
dc.identifier.scopusauthoridNagino, M=7006620971en_HK
dc.identifier.scopusauthoridMaddern, G=26643080100en_HK
dc.identifier.scopusauthoridHugh, TJ=7005891942en_HK
dc.identifier.scopusauthoridVauthey, JN=35270590000en_HK
dc.identifier.scopusauthoridGreig, P=7006982425en_HK
dc.identifier.scopusauthoridRees, M=7201512301en_HK
dc.identifier.scopusauthoridYokoyama, Y=7402993620en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridNimura, Y=7201351672en_HK
dc.identifier.scopusauthoridFigueras, J=7101801203en_HK
dc.identifier.scopusauthoridCapussotti, L=7004492027en_HK
dc.identifier.scopusauthoridBüchler, MW=35277875400en_HK
dc.identifier.scopusauthoridWeitz, J=7102347790en_HK

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