title: Assessment of liver stiffness measurement: novel intraoperative blood loss predictor?
abstract: BACKGROUND
  The risks of massive intraoperative blood loss are of major concern during liver surgery. Various predictors of massive intraoperative blood loss were reported for identifying patients preoperatively with high risk of suffering massive intraoperative blood loss during liver surgery. The assessment of the extent of fibrosis may be a way to predict the risk of the intraoperative blood loss in patients undergoing liver surgery. Liver stiffness measurement by transient elastography is a noninvasive method for assessing liver fibrosis in patients with chronic liver disease. The purpose of this retrospective, single-center study was to assess a correlation between liver stiffness measurement and intraoperative blood loss during liver surgery for determining the role of liver stiffness measurement as a predictor of intraoperative blood loss.
  
  
  METHODS
  A total of 45 patients who underwent elective right hepatectomy from August 2007 to July 2011 were selected. Liver stiffness measurement, tumor size, intraoperative data, and perioperative laboratory data were retrospectively investigated. Correlation analysis was used to find the correlations between variables.
  
  
  RESULTS
  Among the 45 patients enrolled in this study, 43 were ultimately investigated. A statistically positive correlation was found between the intraoperative blood loss and the median liver stiffness measurements (r = 0.420, p = 0.005).
  
  
  CONCLUSIONS
  The liver stiffness measurement is a possible predictor of intraoperative blood loss through the correlation between liver stiffness measurement and the intraoperative blood loss during right hepatectomy.
authors.affiliation: Department of Anesthesiology and Pain Medicine, Anesthesia and Pain Research Institute, Yonsei University College of Medicine, 50 Yonsei-ro, Seodaemun-gu, Seoul 120-752, South Korea. kmsviola@yuhs.ac
authors.forename: Min-Soo
authors.initials: MS
authors.lastname: Kim
authors.forename: Jeong-Rim
authors.initials: JR
authors.lastname: Lee
mesh_terms: D016063:Blood Loss, Surgical; D054459:Elasticity Imaging Techniques; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging*; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies