HPB Surgery

Research Article

Renal Dysfunction Is an Independent Risk Factor for Mortality after Liver Resection and the Main Determinant of Outcome in Posthepatectomy Liver Failure

Table 1

Preoperative and intraoperative characteristics of 501 patients undergoing hepatic resection.
Median (range)Count (%)
Age65 (21–90) 
Gender  
 Female 223 (45)
 Male 278 (55)
Indication for surgery  
 Benign 46 (9)
 Primary  
   Hepatocellular carcinoma 39 (8)
   Cholangiocarcinoma 31 (6)
   Others 28 (6)
 Secondary  
   Colorectal metastases 308 (61)
   Other metastases 49 (10)
Liver directed chemotherapy  
 Yes 176 (35)
 No 325 (65)
Diabetes  
 Yes 55 (11)
 No 446 (89)
BMI26 (16–54) 
ASA Grade  
 1 51 (10)
 2 323 (64)
 3 124 (25)
 4 2 (0.4)
 Not recorded 1 (0.2)
Physiologic risk score16 (12–32) 
Operative risk score24 (14–35) 
Estimated P-POSSUM mortality (%)7.7 (0.9–69.3) 
Confirmed fibrosis/cirrhosis  
 Yes 22 (4)
 No 479 (96)
Preoperative bilirubin (µmol/L)9 (2–162) 
Preoperative haemoglobin (g/dL)13.2 (8.6–17.0) 
Preoperative white cell count (/L)6.9 (2.7–25.0) 
Preoperative albumin (g/L)44 (24–53) 
Preoperative alkaline phosphatase (U/L)95 (34–1190) 
Preoperative creatinine (µmol/L)78 (40–430) 
Preoperative glomerular filtration rate (GFR)  
 >90 mL/min 163 (33)
 <90 mL/min 326 (65)
 Not measured 12 (2)
Preoperative neutrophil lymphocyte ratio (NLR)2.5 (0.3–17.3) 
NLR > 5  
 Yes 59 (12)
 No 442 (88)
Open or laparoscopic approach  
 Open 453 (90)
 Laparoscopic 48 (10)
Radio frequency ablation (RFA) included  
 Yes 23 (5)
 No 478 (95)
Wedge resection included  
 Yes 189 (38)
 No 312 (62)
Operation  
 Right hemihepatectomy 173 (35)
 Extended right hemihepatectomy 34 (7)
 Left hemihepatectomy 64 (13)
 Extended left hemihepatectomy 17 (3)
 Left lateral sectorectomy 48 (10)
 Wedge resection only 133 (27)
 Other 32 (6)
Bile duct reconstruction included  
 Yes 46 (9)
 No 455 (91)
Synchronous bowel procedure  
 Yes 23 (5)
 No 478 (95)
Operation number  
 1st resection 465 (93)
 2nd resection 31 (6)
 3rd resection 5 (1)
Number of segments resected4 (1–6) 
Number of procedures1 (1–10) 
Surgeon’s assessment of liver parenchyma  
 Normal 323 (64)
 Abnormal 171 (34)
 Not recorded 7 (1)
Blood loss 
 <500 mL 246 (49)
 500–999 mL 175 (35)
 ≥1000 mL 76 (15)
 Not recorded 4 (0.8)
Units transfused 0 (0–26)