title: Post-hepatectomy liver failure in patients with colorectal liver metastases.
abstract: Liver resection remains the standard treatment for colorectal liver metastases (CLM). Major hepatic resection is now performed frequently and with relative safety, but postoperative mortality is still reported to occur in up to 6 % of the patients with CLM undergoing liver resection even at high-volume centers. Post-hepatectomy liver failure (PHLF) is a key factor involved in mortality. The frequency of PHLF is reported to be 1-16 %, and has varied greatly among studies since a clear definition of PHLF has been lacking. Recently, the International Study Group of Liver Surgery (ISGLS) proposed a simple definition of PHLF, which includes the combination of the severity of PHLF and does not use an arbitrary cut-off value for the serum bilirubin concentration and INR. Hence, it may be the most useful definition in the clinical setting. Advanced age, a small future liver remnant volume, preoperative chemotherapy and chemotherapy-induced liver injury may all be associated with PHLF. Once PHLF occurs, it is difficult to reverse, and thus, strategies aimed at prevention are keys to reducing the mortality after liver surgery.
authors: Department of Surgery, National Hospital Organization Kyoto Medical Center, Kyoto, Japan. narinari@kuhp.kyoto-u.ac.jp.
authors: Masato
authors: M
authors: Narita
authors: Centre de Chirurgie Viscérale et de Transplantation Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, Strasbourg Cedex, 67098, France.
authors: Elie
authors: E
authors: Oussoultzoglou
authors: Centre de Chirurgie Viscérale et de Transplantation Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, Strasbourg Cedex, 67098, France.
authors: Philippe
authors: P
authors: Bachellier
authors: Centre de Chirurgie Viscérale et de Transplantation Hôpital de Hautepierre, Hôpitaux Universitaires de Strasbourg, Avenue Molière, Strasbourg Cedex, 67098, France.
authors: Daniel
authors: D
authors: Jaeck
authors: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Kyoto, 606-8507, Japan. uemoto@kuhp.kyoto-u.ac.jp.
authors: Shinji
authors: S
authors: Uemoto
mesh_terms: D015179:Colorectal Neoplasms / Q000473:pathology*; D006498:Hepatectomy; D006801:Humans; D017093:Liver Failure / Q000453:epidemiology* / Q000517:prevention & control; D008113:Liver Neoplasms / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D011182:Postoperative Care; D011183:Postoperative Complications / Q000453:epidemiology* / Q000517:prevention & control; D012307:Risk Factors; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Hepatectomy; Liver dysfunction; Liver insufficiency; Morbidity; Mortality
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