ACHBT = Association de Chirurgie Hepato-Bilio-pancreatique et de Transplantation
Patient selection: elective open or laparoscopic liver resection
Outcome: significant biliary leakage (ISGLS grade B or C)
Parameters:
(1) anatomic resection involving segment 8
(2) transection along the right aspect of the left intersectional plane
(3) estimated blood loss in mL
(4) minutes of remnant ischemia after pedicular clamping
(5) associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)
(6) planned vs actual resection
|
Parameter
|
Finding
|
Points
|
|
anatomic resection involving segment 8
|
no
|
0
|
|
|
yes
|
1
|
|
transection along the right aspect of the left intersectional plane
|
no
|
0
|
|
|
yes
|
1
|
|
estimated blood loss
|
< 500 mL
|
0
|
|
|
>= 500 mL
|
1
|
|
minutes of remnant ischemia
|
< 45 minutes
|
0
|
|
|
>= 45 minutes
|
1
|
|
ALPPS
|
no
|
0
|
|
|
yes
|
1
|
|
planned vs actual resection
|
open
|
0
|
|
|
laparoscopic planned and completed
|
0
|
|
|
laparoscopic planned but converted to open
|
1
|
total score =
= SUM(points for all 6 parameters)
Interpretation:
• minimum score: 0
• maximum score: 6
• The higher the score the greater the risk for significant bile leak.
|
Score
|
Risk Group
|
Percent with Significant Bile Leak
|
|
0 or 1
|
low
|
2.6%
|
|
2
|
intermediate
|
9.7%
|
|
3 to 6
|
high
|
29.2%
|
Performance:
• The area under the ROC curve is 0.79.
