Hepatic marker combination provides relevant score to predict severe morbidity after colorectal metastases-related major hepatectomy

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Author Info

Arnaud Pontallier Christophe Laurent Etienne Buscail Fabrice Muscari Jean-Philippe Adam Laurence Chiche Sandrine Dabernat Véronique Vendrely

Corresponding Author

Etienne Buscail
Department of Digestive Surgery, CHU of Bordeaux, Haut-Leveque Hospital, University of Bordeaux Segalen, Pessac, 33600, France

A B S T R A C T

Background and objectives: After hepatic resection, liver failure is not diagnosed until the postoperative day-5. The aim was to identify a biomarker predictive of severe morbidity, the day after major hepatectomy. Methods: This retrospective study included patients undergoing major hepatectomy for colorectal metastases, plasma hepatic marker concentrations being determined at postoperative day-one. Outcomes were 30-day severe morbidity (Dindo III to V) and grade C post-hepatectomy liver failure. Results: A total of 433 patients were included. Thirty-day severe morbidity, 90-day mortality and grade-C post-hepatectomy liver failure rates were 15.5%, 2.5% and 2.5% respectively. Using cut-offs determined by receiver operating characteristic curves the association of serum bilirubin ≥ 2.1 mg/dL (≥ 2 N) and aspartate-amino-transferase ≥ 450 IU/L (≥ 10 N) was selected for the best biochemical predictors of severe morbidity (sensitivity 38%, specificity 94%) and post-hepatectomy failure (sensitivity 100%, specificity 91%). In multivariate analysis, this score was independently associated with severe morbidity (HR = 5.98, 95% IC 2.65-13.89; P < 0.0001) Conclusions: The association of plasma bilirubin ≥ 2.1 mg/dL and aspartate-amino-transferase ≥ 450 IU/L is identified as a relevant predictor of severe morbidity and post-hepatectomy failure as early as the first postoperative day after major hepatectomy for colorectal metastases.

Article Info

Article Type

Research Article

Publication history

Received: Sun 21, Oct 2018
Accepted: Tue 13, Nov 2018
Published: Mon 26, Nov 2018

Copyright

© 2023 Etienne Buscail. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Hosting by Science Repository.
DOI: 10.31487/j.JSO.2018.01.004