Jarnagin et al identified risk factors for morbidity and mortality following an hepatic resection. Several of these risk factors can be predicted prior to surgery. The authors are from Memorial Sloan-Kettering Cancer Center in New York City.


Patient selection: hepatic resection


Risk factors contributing to both morbidity and mortality:

(1) excessive blood loss

(2) number of segments resected (>= 3, out of a total of 10; Figure 2 suggests risk increases when >= 4)

(3) complex hepatectomy (including concurrent major biliary procedure or vascular resection, see previous algorithm above)


Additional risk factors contributing to morbidity:

(1) preoperative hypoalbuminemia

(2) elevated preoperative serum creatinine concentration

(3) significant comorbid condition

(4) male gender


Additional risk factors contributing to mortality:

(1) preoperative thrombocytopenia

(2) advanced age

(3) elevated preoperative serum total bilirubin concentration


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