Evaluation of the New ISGLS Definitions of Typical Posthepatectomy Complications
Evaluation of the New ISGLS Definitions of Typical Posthepatectomy Complications
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DOI：
10.1177/1457496918798202
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发表时间：
2019-06-01
影响因子：
2.4
通讯作者：
Rueckert, F.
中科院分区：
文献类型：
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作者：
Birgin, E.;Tesfazgi, W.;Rueckert, F.
背景和目的：国际肝外科研究小组建立了首个针对术后出血、术后肝功能衰竭和胆漏的国际标准化定义和分级。我们的目的是将这些并发症的定义和分级与术后病程的客观参数，即死亡率和住院时间相关联，以评估其在临床常规中的有效性。方法：2004-2014年间，共有415名患者接受了肝脏手术。对术后出血、术后肝功能衰竭和胆漏与围手术期参数和死亡率的相关性进行了单因素和多因素分析。结果：术后出血A级25例(6.1%)，B级3例(0.7%)，C级1例(0.2%)；术后肝功能A级23例(5.5%)，B级24例(5.8%)，C级7例(1.6%)。胆漏A级10例(2.4%)，胆漏B级24例(5.8%)，C级7例(1.6%)。术后出血B级和C级以及肝功能衰竭A级、B级和C级患者的死亡率显著增加，3例(42.9%)胆漏患者C级死亡。结论：我们的数据表明，新的定义与死亡率和住院时间有很好的相关性。
Background and Objectives: The International Study Group of Liver Surgery established the first internationally standardized definitions and grading for posthepatectomy hemorrhage, posthepatectomy liver failure, and bile leakage. We aimed to correlate these definitions and grades of complications with objective parameters of the postoperative course, namely, mortality and length of stay, to assess the usefulness in clinical routine. Methods: A total of 415 patients underwent hepatic surgery between 2004 and 2014. Uni- and multivariate analyses were made for correlations of posthepatectomy hemorrhage, posthepatectomy liver failure, and bile leakage with perioperative parameters and mortality. Results: Of the total, 25 (6.1%) patients developed a posthepatectomy hemorrhage Grade A, 3 (0.7%) patients a posthepatectomy hemorrhage Grade B, and 1 (0.2%) patient a posthepatectomy hemorrhage Grade C; 23 (5.5%) patients had a posthepatectomy liver failure Grade A, 24 (5.8%) patients a posthepatectomy liver failure Grade B, and 7 patients (1.6%) a posthepatectomy liver failure Grade C. Bile leakage Grade A occurred in 10 (2.4%) patients, bile leakage Grade B in 24 (5.8%) patients, and bile leakage Grade C in 7 (1.6%) patients. Mortality was significantly increased in patients with posthepatectomy hemorrhage Grades B and C and in patients with posthepatectomy liver failure Grades A, B, and C. Three (42.9%) patients with bile leakage Grade C died. Conclusion: Our data indicate that the new definitions correlate well with mortality and duration of hospital stay.