title: Comprehensive review of post-liver resection surgical complications and a new universal classification and grading system.
abstract: Liver resection is the gold standard treatment for certain liver tumors such as hepatocellular carcinoma and metastatic liver tumors. Some patients with such tumors already have reduced liver function due to chronic hepatitis, liver cirrhosis, or chemotherapy-associated steatohepatitis before surgery. Therefore, complications due to poor liver function are inevitable after liver resection. Although the mortality rate of liver resection has been reduced to a few percent in recent case series, its overall morbidity rate is reported to range from 4.1% to 47.7%. The large degree of variation in the post-liver resection morbidity rates reported in previous studies might be due to the lack of consensus regarding the definitions and classification of post-liver resection complications. The Clavien-Dindo (CD) classification of post-operative complications is widely accepted internationally. However, it is hard to apply to some major post-liver resection complications because the consensus definitions and grading systems for post-hepatectomy liver failure and bile leakage established by the International Study Group of Liver Surgery are incompatible with the CD classification. Therefore, a unified classification of post-liver resection complications has to be established to allow comparisons between academic reports.
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Masayuki
authors.initials: M
authors.lastname: Ishii
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Toru
authors.initials: T
authors.lastname: Mizuguchi
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Harada
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Shigenori
authors.initials: S
authors.lastname: Ota
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Makoto
authors.initials: M
authors.lastname: Meguro
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Tomomi
authors.initials: T
authors.lastname: Ueki
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishidate
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Kenji
authors.initials: K
authors.lastname: Okita
authors.affiliation: Masayuki Ishii, Toru Mizuguchi, Kohei Harada, Shigenori Ota, Makoto Meguro, Tomomi Ueki, Toshihiko Nishidate, Kenji Okita, Koichi Hirata, Department of Surgery, Surgical Oncology and Science, Sapporo Medical University Postgraduate School of Medicine, Sapporo, Hokkaido 060-8543, Japan.
authors.forename: Koichi
authors.initials: K
authors.lastname: Hirata
keywords: Ascites; Bile leakage; Coagulation disorder; Complication; Liver failure; Renal failure; Surgical site infection