Liver surgery-specific complications are an independent factor influencing long-term survival following major hepatectomy.


Journal

HPB : the official journal of the International Hepato Pancreato Biliary Association
ISSN: 1477-2574
Titre abrégé: HPB (Oxford)
Pays: England
ID NLM: 100900921

Informations de publication

Date de publication:
10 2021
Historique:
received: 01 09 2020
revised: 06 02 2021
accepted: 16 02 2021
pubmed: 19 4 2021
medline: 27 1 2022
entrez: 18 4 2021
Statut: ppublish

Résumé

A severity grading system for liver surgery-specific complications, given the acronym FABIB, has been standardized to increase the feasibility and comparability of academic reports in liver surgery. Whether the FABIB score is associated with long-term survival following major hepatectomy has not been previously investigated. 297 consecutive patients who had undergone major hepatectomy between 2012 and 2019 were recruited. The postoperative complications were documented according to the FABIB system and, for comparison purposes, Clavien-Dindo classification. Their influence on 90-day mortality and long-term survival was analyzed retrospectively. Taking the relevant confounders into account, the FABIB score was a robust factor associated with long-term survival after major hepatectomy: patients with high FABIB scores (≥6) had a 2.415-fold higher risk of death compared to patients with low FABIB scores (≤2) (P = 0.002). In contrast to that, the Clavien-Dindo Classification (grade III + IV vs. grade I + II) was not associated with survival in our cohort (P = 0.873). Liver surgery-specific complications, measured by the FABIB system, impact long-term survival after major hepatectomy independent of relevant confounders. We propose the FABIB score as a composite endpoint for randomized controlled trials and a quality assessment tool in liver surgery.

Sections du résumé

BACKGROUND
A severity grading system for liver surgery-specific complications, given the acronym FABIB, has been standardized to increase the feasibility and comparability of academic reports in liver surgery. Whether the FABIB score is associated with long-term survival following major hepatectomy has not been previously investigated.
METHODS
297 consecutive patients who had undergone major hepatectomy between 2012 and 2019 were recruited. The postoperative complications were documented according to the FABIB system and, for comparison purposes, Clavien-Dindo classification. Their influence on 90-day mortality and long-term survival was analyzed retrospectively.
RESULTS
Taking the relevant confounders into account, the FABIB score was a robust factor associated with long-term survival after major hepatectomy: patients with high FABIB scores (≥6) had a 2.415-fold higher risk of death compared to patients with low FABIB scores (≤2) (P = 0.002). In contrast to that, the Clavien-Dindo Classification (grade III + IV vs. grade I + II) was not associated with survival in our cohort (P = 0.873).
CONCLUSION
Liver surgery-specific complications, measured by the FABIB system, impact long-term survival after major hepatectomy independent of relevant confounders. We propose the FABIB score as a composite endpoint for randomized controlled trials and a quality assessment tool in liver surgery.

Identifiants

pubmed: 33865711
pii: S1365-182X(21)00065-4
doi: 10.1016/j.hpb.2021.02.013
pii:
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

1496-1505

Informations de copyright

Copyright © 2021 International Hepato-Pancreato-Biliary Association Inc. Published by Elsevier Ltd. All rights reserved.

Auteurs

Marius Kemper (M)

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Germany.

Asmus Heumann (A)

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Germany.

Eric Freiwald-Bibiza (E)

Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Germany.

Björn-Ole Stüben (BO)

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Germany.

Jakob R Izbicki (JR)

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Germany.

Jun Li (J)

Department of General, Visceral and Thoracic Surgery, University Medical Centre Hamburg-Eppendorf, Germany. Electronic address: j.li@uke.de.

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