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 |
Specialty: Gastroenterology, Surgery, general, Surgery, orthopedic