Description

The International Study Group of Liver Surgery (ISGLS) developed a classification for the severity of posthepatectomy liver failure (PHLF).


 

In hepatic failure the liver is not capable of providing synthetic, excretory and detoxifying functions.

 

Patient selection: status post hepatic resection

 

Criteria for posthepatectomy liver failure (PHLF):

(1) Prolongation of the INR and increases in total serum bilirubin on postoperative day 5 compared to postoperative day 4.

(2) The change cannot be explained by biliary obstruction or other obvious cause.

 

where:

• Evaluation of INR and total serum bilirubin on day 5 is similar to the 50-50 criteria of Balzan et al.

 

Parameters for a patient with evidence of PHLF:

(1) adherence to standard management protocol

(2) invasive procedure required

 

Adherence to Standard Protocol

Invasive Procedure Required

Grade

no change

NA

A

change

no

B

change

yes

C

 


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