الفهرس | Only 14 pages are availabe for public view |
Abstract Liver failure is a fatal complication that sometimes follows a partial hepatic resection. In general, post-resection liver failure (PHLF) is characterized as failure of one or more of the hepatic synthetic and excretory functions that include hyperbilirubinemia, hypoalbuminaemia, prolonged prothrombin time, elevated serum lactate and/or different grades of hepatic encephalopathy.According to the so-called 50–50 criteria, PHLF is described as prothrombin index less than 50% [international normalized ratio (INR)>1.7] and serum bilirubin more than 50 µmol/l (2.9 mg/dl) on postoperative day 5. Moreover, a peak bilirubin of 7.0 mg/dl (120 µmol/l) was identified as sensitive and specific for prediction of PHLF-related death.Based on the current study we found that the predictors for PHLF were albumin < 3.5 g/dl, MELD score > 9, Child score > 5, blood loss exceeded 500 ml and major resection. Application of these factors in the preoperative assessment of liver function prior to hepatic resection is recommended. Also, we recommended; Perform such studies on large scale of patients in multiple centers. |