Qadan et al listed risk factors associated with postoperative hepatic failure following a hepatic resection. These can help to identify a patient who may benefit from more aggressive or an alternative management. The authors are from Memorial Sloan Kettering Cancer Center.


Patient selection: hepatic resection


Outcome: postoperative hepatic failure


Risk factors:

(1) age > 70 years

(2) male gender

(3) cirrhosis or hepatic fibrosis

(4) hepatitis

(5) large intraoperative blood loss

(6) multiple perioperative blood transfusions

(7) prolonged operative time

(8) hepatic ischemia

(9) obstructive jaundice

(10) preoperative chemotherapy

(11) steatosis or steatohepatitis

(12) extended hepatectomy and/or small hepatic remnant

(13) preoperative hypoalbuminemia (and malnutrition)


The risk for postoperative hepatic failure increases with the number of risk factors present.


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