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Preoperative Factors of Qadan et al Associated with a Low Risk of Postoperative Hepatic Failure Following Hepatic Resection in a Patient with Cirrhosis

Description

Qadan et al identified preoperative factors associated with a low risk of postoperative hepatic failure following hepatic resection in a patient with cirrhosis. 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 in a patient with cirrhosis

 

Outcome: postoperative hepatic failure (POHF)

 

Parameters:

(1) Child-Pugh class

(2) platelet count per µL

(3) clinically significant portal hypertension

(4) anticipated hepatic remnant after the resection in percent

(5) indocyanine green retention in percent

Parameter

Finding

Points

Child-Pugh class

A

1

 

B or C

0

platelet count

> 100,000 per µL

1

 

<= 100,000 per µL

0

portal hypertension

absent or minor

1

 

clinically significant

0

percent hepatic remnant

> 40%

1

 

<= 40%

0

indocyanine green retention

< 15%

1

 

>= 15%

0

 

Interpretation:

• minimum score: 0

• maximum score: 5

• The higher the score the better the patient's status.

 

Performance:

• Prediction of postoperative hepatic failure risk is imperfect and even a patient who appears to be low risk can develop hepatic failure,

 


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