AustralieFrV1, PascalFrancis, Corpus, bibRecord, 001D87

Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

Identifieur interne : 001D87 ( PascalFrancis/Corpus ); précédent : 001D86; suivant : 001D88

Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

Auteurs : Nuh N. Rahbari ; O. James Garden ; Robert Padbury ; Mark Brooke-Smith ; Michael Crawford ; Rene Adam ; Moritz Koch ; Masatoshi Makuuchi ; Ronald P. Dematteo ; Christopher Christophi ; Simon Banting ; Val Usatoff ; Masato Nagino ; Guy Maddern ; Thomas J. Hugh ; Jean-Nicolas Vauthey ; Paul Greig ; Myrddin Rees ; Yukihiro Yokoyama ; SHEUNG TAT FAN ; Yuji Nimura ; Joan Figueras ; Lorenzo Capussotti ; Markus W. Büchler ; Jürgen Weitz

Source :

Surgery [ 0039-6060 ] ; 2011.

RBID : Pascal:11-0227318

Descripteurs français

Pascal (Inist)
- Insuffisance hépatique, Définition, Grade histologique, Chirurgie, International, Monde, Foie, Médecine, Traitement.

English descriptors

KwdEn :
- Definition, Histological grading, International, Liver, Liver failure, Medicine, Surgery, Treatment, World.

Abstract

Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.

Notice en format standard (ISO 2709)

Pour connaître la documentation sur le format Inist Standard.

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A11	`02`	`1`		`@1 GARDEN (O. James)`
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A11	`18`	`1`		`@1 REES (Myrddin)`
A11	`19`	`1`		`@1 YOKOYAMA (Yukihiro)`
A11	`20`	`1`		`@1 SHEUNG TAT FAN`
A11	`21`	`1`		`@1 NIMURA (Yuji)`
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A14	`06`			`@1 AP-HP Hôpital Paul Brousse,Centre Hépato-Biliaire @2 Villejuif @3 FRA @Z 6 aut.`
A14	`07`			`@1 Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division Graduate School of Medicine University of Tokyo @2 Tokyo @3 JPN @Z 8 aut.`
A14	`08`			`@1 Department of Surgery,Memorial Sloan-Kettering Cancer Center @2 New York, NY @3 USA @Z 9 aut.`
A14	`09`			`@1 Department of Surgery,Melbourne University @3 AUS @Z 10 aut. @Z 19 aut.`
A14	`10`			`@1 Hepatobiliary Surgery,St Vincent's Hospital @2 Melbourne, Victoria @3 AUS @Z 11 aut.`
A14	`11`			`@1 Department of Surgery,Alfred Hospital @2 Melbourne @3 AUS @Z 12 aut.`
A14	`12`			`@1 Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine @2 Nagoya @3 JPN @Z 13 aut. @Z 21 aut.`
A14	`13`			`@1 University of Adelaide Discipline of Surgery,The Queen Elizabeth Hospital @2 Woodville @3 AUS @Z 14 aut.`
A14	`14`			`@1 Department of Gastrointestinal Surgery,Royal North Shore Hospital @2 Sydney @3 AUS @Z 15 aut.`
A14	`15`			`@1 Department of Surgical Oncology,The University of Texas M. D. Anderson Cancer Center @2 Houston, TX @3 USA @Z 16 aut.`
A14	`16`			`@1 Department of Surgery,Toronto General Hospital, University of Toronto @2 Toronto @3 CAN @Z 17 aut.`
A14	`17`			`@1 Department of Hepatobiliary Surgery,North Hampshire Hospital @2 Basingstoke @3 GBR @Z 18 aut.`
A14	`18`			`@1 Department of Surgery,Queen Mary Hospital, University of Hong Kong @3 HKG @Z 20 aut.`
A14	`19`			`@1 Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona @2 Crirona @3 ESP @Z 22 aut.`
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C01	`01`		`ENG`	@0 Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.
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Format Inist (serveur)

NO :	PASCAL 11-0227318 INIST
ET :	Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)
AU :	RAHBARI (Nuh N.); GARDEN (O. James); PADBURY (Robert); BROOKE-SMITH (Mark); CRAWFORD (Michael); ADAM (Rene); KOCH (Moritz); MAKUUCHI (Masatoshi); DEMATTEO (Ronald P.); CHRISTOPHI (Christopher); BANTING (Simon); USATOFF (Val); NAGINO (Masato); MADDERN (Guy); HUGH (Thomas J.); VAUTHEY (Jean-Nicolas); GREIG (Paul); REES (Myrddin); YOKOYAMA (Yukihiro); SHEUNG TAT FAN; NIMURA (Yuji); FIGUERAS (Joan); CAPUSSOTTI (Lorenzo); BÜCHLER (Markus W.); WEITZ (Jürgen)
AF :	Department of General, Visceral and Transplantation Surgery,University of Heidelberg/Allemagne (1 aut., 7 aut., 24 aut., 25 aut.); Department of Clinical & Surgical Sciences, University of Edinburgh/Edinburgh/Royaume-Uni (2 aut.); Department of Surgery, Flinders Medical Centre/Adelaide/Australie (3 aut.); Hepatopancreatobiliary and Transplant Surgery, Flinders Medical Centre/Adelaide/Australie (4 aut.); Hepatopancreatobiliary and Transplant Surgery,Royal Prince Alfred Hospital/Sydney/Australie (5 aut.); AP-HP Hôpital Paul Brousse,Centre Hépato-Biliaire/Villejuif/France (6 aut.); Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division Graduate School of Medicine University of Tokyo/Tokyo/Japon (8 aut.); Department of Surgery,Memorial Sloan-Kettering Cancer Center/New York, NY/Etats-Unis (9 aut.); Department of Surgery,Melbourne University/Australie (10 aut., 19 aut.); Hepatobiliary Surgery,St Vincent's Hospital/Melbourne, Victoria/Australie (11 aut.); Department of Surgery,Alfred Hospital/Melbourne/Australie (12 aut.); Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine/Nagoya/Japon (13 aut., 21 aut.); University of Adelaide Discipline of Surgery,The Queen Elizabeth Hospital/Woodville/Australie (14 aut.); Department of Gastrointestinal Surgery,Royal North Shore Hospital/Sydney/Australie (15 aut.); Department of Surgical Oncology,The University of Texas M. D. Anderson Cancer Center/Houston, TX/Etats-Unis (16 aut.); Department of Surgery,Toronto General Hospital, University of Toronto/Toronto/Canada (17 aut.); Department of Hepatobiliary Surgery,North Hampshire Hospital/Basingstoke/Royaume-Uni (18 aut.); Department of Surgery,Queen Mary Hospital, University of Hong Kong/Hong-Kong (20 aut.); Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona/Crirona/Espagne (22 aut.); Division of Surgical Oncology,Institute of Cancer Research and Treatment/Candiolo, Turin/Italie (23 aut.)
DT :	Publication en série; Niveau analytique
SO :	Surgery; ISSN 0039-6060; Coden SURGAZ; Etats-Unis; Da. 2011; Vol. 149; No. 5; Pp. 713-724; Bibl. 79 ref.
LA :	Anglais
EA :	Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.
CC :	002B01; 002B13C03
FD :	Insuffisance hépatique; Définition; Grade histologique; Chirurgie; International; Monde; Foie; Médecine; Traitement
FG :	Pathologie de l'appareil digestif; Pathologie du foie; Appareil digestif
ED :	Liver failure; Definition; Histological grading; Surgery; International; World; Liver; Medicine; Treatment
EG :	Digestive diseases; Hepatic disease; Digestive system
SD :	Insuficiencia hepática; Definición; Grado histológico; Cirugía; Internacional; Mundo; Hígado; Medicina; Tratamiento
LO :	INIST-2063.354000192059550150
ID :	11-0227318

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Pascal:11-0227318

Le document en format XML

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<author><name sortKey="Christophi, Christopher" sort="Christophi, Christopher" uniqKey="Christophi C" first="Christopher" last="Christophi">Christopher Christophi</name>
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<author><name sortKey="Banting, Simon" sort="Banting, Simon" uniqKey="Banting S" first="Simon" last="Banting">Simon Banting</name>
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<author><name sortKey="Nagino, Masato" sort="Nagino, Masato" uniqKey="Nagino M" first="Masato" last="Nagino">Masato Nagino</name>
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<author><name sortKey="Maddern, Guy" sort="Maddern, Guy" uniqKey="Maddern G" first="Guy" last="Maddern">Guy Maddern</name>
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<author><name sortKey="Hugh, Thomas J" sort="Hugh, Thomas J" uniqKey="Hugh T" first="Thomas J." last="Hugh">Thomas J. Hugh</name>
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<author><name sortKey="Vauthey, Jean Nicolas" sort="Vauthey, Jean Nicolas" uniqKey="Vauthey J" first="Jean-Nicolas" last="Vauthey">Jean-Nicolas Vauthey</name>
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<author><name sortKey="Greig, Paul" sort="Greig, Paul" uniqKey="Greig P" first="Paul" last="Greig">Paul Greig</name>
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</author>
<author><name sortKey="Rees, Myrddin" sort="Rees, Myrddin" uniqKey="Rees M" first="Myrddin" last="Rees">Myrddin Rees</name>
<affiliation><inist:fA14 i1="17"><s1>Department of Hepatobiliary Surgery,North Hampshire Hospital</s1>
<s2>Basingstoke</s2>
<s3>GBR</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Yokoyama, Yukihiro" sort="Yokoyama, Yukihiro" uniqKey="Yokoyama Y" first="Yukihiro" last="Yokoyama">Yukihiro Yokoyama</name>
<affiliation><inist:fA14 i1="09"><s1>Department of Surgery,Melbourne University</s1>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>19 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Sheung Tat Fan" sort="Sheung Tat Fan" uniqKey="Sheung Tat Fan" last="Sheung Tat Fan">SHEUNG TAT FAN</name>
<affiliation><inist:fA14 i1="18"><s1>Department of Surgery,Queen Mary Hospital, University of Hong Kong</s1>
<s3>HKG</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Nimura, Yuji" sort="Nimura, Yuji" uniqKey="Nimura Y" first="Yuji" last="Nimura">Yuji Nimura</name>
<affiliation><inist:fA14 i1="12"><s1>Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine</s1>
<s2>Nagoya</s2>
<s3>JPN</s3>
<sZ>13 aut.</sZ>
<sZ>21 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Figueras, Joan" sort="Figueras, Joan" uniqKey="Figueras J" first="Joan" last="Figueras">Joan Figueras</name>
<affiliation><inist:fA14 i1="19"><s1>Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona</s1>
<s2>Crirona</s2>
<s3>ESP</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Capussotti, Lorenzo" sort="Capussotti, Lorenzo" uniqKey="Capussotti L" first="Lorenzo" last="Capussotti">Lorenzo Capussotti</name>
<affiliation><inist:fA14 i1="20"><s1>Division of Surgical Oncology,Institute of Cancer Research and Treatment</s1>
<s2>Candiolo, Turin</s2>
<s3>ITA</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Buchler, Markus W" sort="Buchler, Markus W" uniqKey="Buchler M" first="Markus W." last="Büchler">Markus W. Büchler</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Weitz, Jurgen" sort="Weitz, Jurgen" uniqKey="Weitz J" first="Jürgen" last="Weitz">Jürgen Weitz</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
</titleStmt>
<publicationStmt><idno type="wicri:source">INIST</idno>
<idno type="inist">11-0227318</idno>
<date when="2011">2011</date>
<idno type="stanalyst">PASCAL 11-0227318 INIST</idno>
<idno type="RBID">Pascal:11-0227318</idno>
<idno type="wicri:Area/PascalFrancis/Corpus">001D87</idno>
</publicationStmt>
<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)</title>
<author><name sortKey="Rahbari, Nuh N" sort="Rahbari, Nuh N" uniqKey="Rahbari N" first="Nuh N." last="Rahbari">Nuh N. Rahbari</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Garden, O James" sort="Garden, O James" uniqKey="Garden O" first="O. James" last="Garden">O. James Garden</name>
<affiliation><inist:fA14 i1="02"><s1>Department of Clinical & Surgical Sciences, University of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Padbury, Robert" sort="Padbury, Robert" uniqKey="Padbury R" first="Robert" last="Padbury">Robert Padbury</name>
<affiliation><inist:fA14 i1="03"><s1>Department of Surgery, Flinders Medical Centre</s1>
<s2>Adelaide</s2>
<s3>AUS</s3>
<sZ>3 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Brooke Smith, Mark" sort="Brooke Smith, Mark" uniqKey="Brooke Smith M" first="Mark" last="Brooke-Smith">Mark Brooke-Smith</name>
<affiliation><inist:fA14 i1="04"><s1>Hepatopancreatobiliary and Transplant Surgery, Flinders Medical Centre</s1>
<s2>Adelaide</s2>
<s3>AUS</s3>
<sZ>4 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Crawford, Michael" sort="Crawford, Michael" uniqKey="Crawford M" first="Michael" last="Crawford">Michael Crawford</name>
<affiliation><inist:fA14 i1="05"><s1>Hepatopancreatobiliary and Transplant Surgery,Royal Prince Alfred Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>5 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Adam, Rene" sort="Adam, Rene" uniqKey="Adam R" first="Rene" last="Adam">Rene Adam</name>
<affiliation><inist:fA14 i1="06"><s1>AP-HP Hôpital Paul Brousse,Centre Hépato-Biliaire</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Koch, Moritz" sort="Koch, Moritz" uniqKey="Koch M" first="Moritz" last="Koch">Moritz Koch</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Makuuchi, Masatoshi" sort="Makuuchi, Masatoshi" uniqKey="Makuuchi M" first="Masatoshi" last="Makuuchi">Masatoshi Makuuchi</name>
<affiliation><inist:fA14 i1="07"><s1>Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division Graduate School of Medicine University of Tokyo</s1>
<s2>Tokyo</s2>
<s3>JPN</s3>
<sZ>8 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Dematteo, Ronald P" sort="Dematteo, Ronald P" uniqKey="Dematteo R" first="Ronald P." last="Dematteo">Ronald P. Dematteo</name>
<affiliation><inist:fA14 i1="08"><s1>Department of Surgery,Memorial Sloan-Kettering Cancer Center</s1>
<s2>New York, NY</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Christophi, Christopher" sort="Christophi, Christopher" uniqKey="Christophi C" first="Christopher" last="Christophi">Christopher Christophi</name>
<affiliation><inist:fA14 i1="09"><s1>Department of Surgery,Melbourne University</s1>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>19 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Banting, Simon" sort="Banting, Simon" uniqKey="Banting S" first="Simon" last="Banting">Simon Banting</name>
<affiliation><inist:fA14 i1="10"><s1>Hepatobiliary Surgery,St Vincent's Hospital</s1>
<s2>Melbourne, Victoria</s2>
<s3>AUS</s3>
<sZ>11 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Usatoff, Val" sort="Usatoff, Val" uniqKey="Usatoff V" first="Val" last="Usatoff">Val Usatoff</name>
<affiliation><inist:fA14 i1="11"><s1>Department of Surgery,Alfred Hospital</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>12 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Nagino, Masato" sort="Nagino, Masato" uniqKey="Nagino M" first="Masato" last="Nagino">Masato Nagino</name>
<affiliation><inist:fA14 i1="12"><s1>Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine</s1>
<s2>Nagoya</s2>
<s3>JPN</s3>
<sZ>13 aut.</sZ>
<sZ>21 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Maddern, Guy" sort="Maddern, Guy" uniqKey="Maddern G" first="Guy" last="Maddern">Guy Maddern</name>
<affiliation><inist:fA14 i1="13"><s1>University of Adelaide Discipline of Surgery,The Queen Elizabeth Hospital</s1>
<s2>Woodville</s2>
<s3>AUS</s3>
<sZ>14 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Hugh, Thomas J" sort="Hugh, Thomas J" uniqKey="Hugh T" first="Thomas J." last="Hugh">Thomas J. Hugh</name>
<affiliation><inist:fA14 i1="14"><s1>Department of Gastrointestinal Surgery,Royal North Shore Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>15 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Vauthey, Jean Nicolas" sort="Vauthey, Jean Nicolas" uniqKey="Vauthey J" first="Jean-Nicolas" last="Vauthey">Jean-Nicolas Vauthey</name>
<affiliation><inist:fA14 i1="15"><s1>Department of Surgical Oncology,The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston, TX</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Greig, Paul" sort="Greig, Paul" uniqKey="Greig P" first="Paul" last="Greig">Paul Greig</name>
<affiliation><inist:fA14 i1="16"><s1>Department of Surgery,Toronto General Hospital, University of Toronto</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>17 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Rees, Myrddin" sort="Rees, Myrddin" uniqKey="Rees M" first="Myrddin" last="Rees">Myrddin Rees</name>
<affiliation><inist:fA14 i1="17"><s1>Department of Hepatobiliary Surgery,North Hampshire Hospital</s1>
<s2>Basingstoke</s2>
<s3>GBR</s3>
<sZ>18 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Yokoyama, Yukihiro" sort="Yokoyama, Yukihiro" uniqKey="Yokoyama Y" first="Yukihiro" last="Yokoyama">Yukihiro Yokoyama</name>
<affiliation><inist:fA14 i1="09"><s1>Department of Surgery,Melbourne University</s1>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>19 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Sheung Tat Fan" sort="Sheung Tat Fan" uniqKey="Sheung Tat Fan" last="Sheung Tat Fan">SHEUNG TAT FAN</name>
<affiliation><inist:fA14 i1="18"><s1>Department of Surgery,Queen Mary Hospital, University of Hong Kong</s1>
<s3>HKG</s3>
<sZ>20 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Nimura, Yuji" sort="Nimura, Yuji" uniqKey="Nimura Y" first="Yuji" last="Nimura">Yuji Nimura</name>
<affiliation><inist:fA14 i1="12"><s1>Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine</s1>
<s2>Nagoya</s2>
<s3>JPN</s3>
<sZ>13 aut.</sZ>
<sZ>21 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Figueras, Joan" sort="Figueras, Joan" uniqKey="Figueras J" first="Joan" last="Figueras">Joan Figueras</name>
<affiliation><inist:fA14 i1="19"><s1>Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona</s1>
<s2>Crirona</s2>
<s3>ESP</s3>
<sZ>22 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Capussotti, Lorenzo" sort="Capussotti, Lorenzo" uniqKey="Capussotti L" first="Lorenzo" last="Capussotti">Lorenzo Capussotti</name>
<affiliation><inist:fA14 i1="20"><s1>Division of Surgical Oncology,Institute of Cancer Research and Treatment</s1>
<s2>Candiolo, Turin</s2>
<s3>ITA</s3>
<sZ>23 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Buchler, Markus W" sort="Buchler, Markus W" uniqKey="Buchler M" first="Markus W." last="Büchler">Markus W. Büchler</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
<author><name sortKey="Weitz, Jurgen" sort="Weitz, Jurgen" uniqKey="Weitz J" first="Jürgen" last="Weitz">Jürgen Weitz</name>
<affiliation><inist:fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</inist:fA14>
</affiliation>
</author>
</analytic>
<series><title level="j" type="main">Surgery</title>
<title level="j" type="abbreviated">Surgery</title>
<idno type="ISSN">0039-6060</idno>
<imprint><date when="2011">2011</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
<seriesStmt><title level="j" type="main">Surgery</title>
<title level="j" type="abbreviated">Surgery</title>
<idno type="ISSN">0039-6060</idno>
</seriesStmt>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Definition</term>
<term>Histological grading</term>
<term>International</term>
<term>Liver</term>
<term>Liver failure</term>
<term>Medicine</term>
<term>Surgery</term>
<term>Treatment</term>
<term>World</term>
</keywords>
<keywords scheme="Pascal" xml:lang="fr"><term>Insuffisance hépatique</term>
<term>Définition</term>
<term>Grade histologique</term>
<term>Chirurgie</term>
<term>International</term>
<term>Monde</term>
<term>Foie</term>
<term>Médecine</term>
<term>Traitement</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en">Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.</div>
</front>
</TEI>
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<fA08 i1="01" i2="1" l="ENG"><s1>Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)</s1>
</fA08>
<fA11 i1="01" i2="1"><s1>RAHBARI (Nuh N.)</s1>
</fA11>
<fA11 i1="02" i2="1"><s1>GARDEN (O. James)</s1>
</fA11>
<fA11 i1="03" i2="1"><s1>PADBURY (Robert)</s1>
</fA11>
<fA11 i1="04" i2="1"><s1>BROOKE-SMITH (Mark)</s1>
</fA11>
<fA11 i1="05" i2="1"><s1>CRAWFORD (Michael)</s1>
</fA11>
<fA11 i1="06" i2="1"><s1>ADAM (Rene)</s1>
</fA11>
<fA11 i1="07" i2="1"><s1>KOCH (Moritz)</s1>
</fA11>
<fA11 i1="08" i2="1"><s1>MAKUUCHI (Masatoshi)</s1>
</fA11>
<fA11 i1="09" i2="1"><s1>DEMATTEO (Ronald P.)</s1>
</fA11>
<fA11 i1="10" i2="1"><s1>CHRISTOPHI (Christopher)</s1>
</fA11>
<fA11 i1="11" i2="1"><s1>BANTING (Simon)</s1>
</fA11>
<fA11 i1="12" i2="1"><s1>USATOFF (Val)</s1>
</fA11>
<fA11 i1="13" i2="1"><s1>NAGINO (Masato)</s1>
</fA11>
<fA11 i1="14" i2="1"><s1>MADDERN (Guy)</s1>
</fA11>
<fA11 i1="15" i2="1"><s1>HUGH (Thomas J.)</s1>
</fA11>
<fA11 i1="16" i2="1"><s1>VAUTHEY (Jean-Nicolas)</s1>
</fA11>
<fA11 i1="17" i2="1"><s1>GREIG (Paul)</s1>
</fA11>
<fA11 i1="18" i2="1"><s1>REES (Myrddin)</s1>
</fA11>
<fA11 i1="19" i2="1"><s1>YOKOYAMA (Yukihiro)</s1>
</fA11>
<fA11 i1="20" i2="1"><s1>SHEUNG TAT FAN</s1>
</fA11>
<fA11 i1="21" i2="1"><s1>NIMURA (Yuji)</s1>
</fA11>
<fA11 i1="22" i2="1"><s1>FIGUERAS (Joan)</s1>
</fA11>
<fA11 i1="23" i2="1"><s1>CAPUSSOTTI (Lorenzo)</s1>
</fA11>
<fA11 i1="24" i2="1"><s1>BÜCHLER (Markus W.)</s1>
</fA11>
<fA11 i1="25" i2="1"><s1>WEITZ (Jürgen)</s1>
</fA11>
<fA14 i1="01"><s1>Department of General, Visceral and Transplantation Surgery,University of Heidelberg</s1>
<s3>DEU</s3>
<sZ>1 aut.</sZ>
<sZ>7 aut.</sZ>
<sZ>24 aut.</sZ>
<sZ>25 aut.</sZ>
</fA14>
<fA14 i1="02"><s1>Department of Clinical & Surgical Sciences, University of Edinburgh</s1>
<s2>Edinburgh</s2>
<s3>GBR</s3>
<sZ>2 aut.</sZ>
</fA14>
<fA14 i1="03"><s1>Department of Surgery, Flinders Medical Centre</s1>
<s2>Adelaide</s2>
<s3>AUS</s3>
<sZ>3 aut.</sZ>
</fA14>
<fA14 i1="04"><s1>Hepatopancreatobiliary and Transplant Surgery, Flinders Medical Centre</s1>
<s2>Adelaide</s2>
<s3>AUS</s3>
<sZ>4 aut.</sZ>
</fA14>
<fA14 i1="05"><s1>Hepatopancreatobiliary and Transplant Surgery,Royal Prince Alfred Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>5 aut.</sZ>
</fA14>
<fA14 i1="06"><s1>AP-HP Hôpital Paul Brousse,Centre Hépato-Biliaire</s1>
<s2>Villejuif</s2>
<s3>FRA</s3>
<sZ>6 aut.</sZ>
</fA14>
<fA14 i1="07"><s1>Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division Graduate School of Medicine University of Tokyo</s1>
<s2>Tokyo</s2>
<s3>JPN</s3>
<sZ>8 aut.</sZ>
</fA14>
<fA14 i1="08"><s1>Department of Surgery,Memorial Sloan-Kettering Cancer Center</s1>
<s2>New York, NY</s2>
<s3>USA</s3>
<sZ>9 aut.</sZ>
</fA14>
<fA14 i1="09"><s1>Department of Surgery,Melbourne University</s1>
<s3>AUS</s3>
<sZ>10 aut.</sZ>
<sZ>19 aut.</sZ>
</fA14>
<fA14 i1="10"><s1>Hepatobiliary Surgery,St Vincent's Hospital</s1>
<s2>Melbourne, Victoria</s2>
<s3>AUS</s3>
<sZ>11 aut.</sZ>
</fA14>
<fA14 i1="11"><s1>Department of Surgery,Alfred Hospital</s1>
<s2>Melbourne</s2>
<s3>AUS</s3>
<sZ>12 aut.</sZ>
</fA14>
<fA14 i1="12"><s1>Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine</s1>
<s2>Nagoya</s2>
<s3>JPN</s3>
<sZ>13 aut.</sZ>
<sZ>21 aut.</sZ>
</fA14>
<fA14 i1="13"><s1>University of Adelaide Discipline of Surgery,The Queen Elizabeth Hospital</s1>
<s2>Woodville</s2>
<s3>AUS</s3>
<sZ>14 aut.</sZ>
</fA14>
<fA14 i1="14"><s1>Department of Gastrointestinal Surgery,Royal North Shore Hospital</s1>
<s2>Sydney</s2>
<s3>AUS</s3>
<sZ>15 aut.</sZ>
</fA14>
<fA14 i1="15"><s1>Department of Surgical Oncology,The University of Texas M. D. Anderson Cancer Center</s1>
<s2>Houston, TX</s2>
<s3>USA</s3>
<sZ>16 aut.</sZ>
</fA14>
<fA14 i1="16"><s1>Department of Surgery,Toronto General Hospital, University of Toronto</s1>
<s2>Toronto</s2>
<s3>CAN</s3>
<sZ>17 aut.</sZ>
</fA14>
<fA14 i1="17"><s1>Department of Hepatobiliary Surgery,North Hampshire Hospital</s1>
<s2>Basingstoke</s2>
<s3>GBR</s3>
<sZ>18 aut.</sZ>
</fA14>
<fA14 i1="18"><s1>Department of Surgery,Queen Mary Hospital, University of Hong Kong</s1>
<s3>HKG</s3>
<sZ>20 aut.</sZ>
</fA14>
<fA14 i1="19"><s1>Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona</s1>
<s2>Crirona</s2>
<s3>ESP</s3>
<sZ>22 aut.</sZ>
</fA14>
<fA14 i1="20"><s1>Division of Surgical Oncology,Institute of Cancer Research and Treatment</s1>
<s2>Candiolo, Turin</s2>
<s3>ITA</s3>
<sZ>23 aut.</sZ>
</fA14>
<fA20><s1>713-724</s1>
</fA20>
<fA21><s1>2011</s1>
</fA21>
<fA23 i1="01"><s0>ENG</s0>
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</fA45>
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</fA47>
<fA60><s1>P</s1>
</fA60>
<fA61><s0>A</s0>
</fA61>
<fA64 i1="01" i2="1"><s0>Surgery</s0>
</fA64>
<fA66 i1="01"><s0>USA</s0>
</fA66>
<fC01 i1="01" l="ENG"><s0>Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.</s0>
</fC01>
<fC02 i1="01" i2="X"><s0>002B01</s0>
</fC02>
<fC02 i1="02" i2="X"><s0>002B13C03</s0>
</fC02>
<fC03 i1="01" i2="X" l="FRE"><s0>Insuffisance hépatique</s0>
<s5>01</s5>
</fC03>
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<s5>01</s5>
</fC03>
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<s5>01</s5>
</fC03>
<fC03 i1="02" i2="X" l="FRE"><s0>Définition</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="ENG"><s0>Definition</s0>
<s5>02</s5>
</fC03>
<fC03 i1="02" i2="X" l="SPA"><s0>Definición</s0>
<s5>02</s5>
</fC03>
<fC03 i1="03" i2="X" l="FRE"><s0>Grade histologique</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="ENG"><s0>Histological grading</s0>
<s5>03</s5>
</fC03>
<fC03 i1="03" i2="X" l="SPA"><s0>Grado histológico</s0>
<s5>03</s5>
</fC03>
<fC03 i1="04" i2="X" l="FRE"><s0>Chirurgie</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="ENG"><s0>Surgery</s0>
<s5>04</s5>
</fC03>
<fC03 i1="04" i2="X" l="SPA"><s0>Cirugía</s0>
<s5>04</s5>
</fC03>
<fC03 i1="05" i2="X" l="FRE"><s0>International</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="ENG"><s0>International</s0>
<s5>05</s5>
</fC03>
<fC03 i1="05" i2="X" l="SPA"><s0>Internacional</s0>
<s5>05</s5>
</fC03>
<fC03 i1="06" i2="X" l="FRE"><s0>Monde</s0>
<s2>NG</s2>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="ENG"><s0>World</s0>
<s2>NG</s2>
<s5>06</s5>
</fC03>
<fC03 i1="06" i2="X" l="SPA"><s0>Mundo</s0>
<s2>NG</s2>
<s5>06</s5>
</fC03>
<fC03 i1="07" i2="X" l="FRE"><s0>Foie</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="ENG"><s0>Liver</s0>
<s5>08</s5>
</fC03>
<fC03 i1="07" i2="X" l="SPA"><s0>Hígado</s0>
<s5>08</s5>
</fC03>
<fC03 i1="08" i2="X" l="FRE"><s0>Médecine</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="ENG"><s0>Medicine</s0>
<s5>09</s5>
</fC03>
<fC03 i1="08" i2="X" l="SPA"><s0>Medicina</s0>
<s5>09</s5>
</fC03>
<fC03 i1="09" i2="X" l="FRE"><s0>Traitement</s0>
<s5>25</s5>
</fC03>
<fC03 i1="09" i2="X" l="ENG"><s0>Treatment</s0>
<s5>25</s5>
</fC03>
<fC03 i1="09" i2="X" l="SPA"><s0>Tratamiento</s0>
<s5>25</s5>
</fC03>
<fC07 i1="01" i2="X" l="FRE"><s0>Pathologie de l'appareil digestif</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="ENG"><s0>Digestive diseases</s0>
<s5>37</s5>
</fC07>
<fC07 i1="01" i2="X" l="SPA"><s0>Aparato digestivo patología</s0>
<s5>37</s5>
</fC07>
<fC07 i1="02" i2="X" l="FRE"><s0>Pathologie du foie</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="ENG"><s0>Hepatic disease</s0>
<s5>38</s5>
</fC07>
<fC07 i1="02" i2="X" l="SPA"><s0>Hígado patología</s0>
<s5>38</s5>
</fC07>
<fC07 i1="03" i2="X" l="FRE"><s0>Appareil digestif</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="ENG"><s0>Digestive system</s0>
<s5>39</s5>
</fC07>
<fC07 i1="03" i2="X" l="SPA"><s0>Aparato digestivo</s0>
<s5>39</s5>
</fC07>
<fN21><s1>150</s1>
</fN21>
<fN44 i1="01"><s1>OTO</s1>
</fN44>
<fN82><s1>OTO</s1>
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<server><NO>PASCAL 11-0227318 INIST</NO>
<ET>Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)</ET>
<AU>RAHBARI (Nuh N.); GARDEN (O. James); PADBURY (Robert); BROOKE-SMITH (Mark); CRAWFORD (Michael); ADAM (Rene); KOCH (Moritz); MAKUUCHI (Masatoshi); DEMATTEO (Ronald P.); CHRISTOPHI (Christopher); BANTING (Simon); USATOFF (Val); NAGINO (Masato); MADDERN (Guy); HUGH (Thomas J.); VAUTHEY (Jean-Nicolas); GREIG (Paul); REES (Myrddin); YOKOYAMA (Yukihiro); SHEUNG TAT FAN; NIMURA (Yuji); FIGUERAS (Joan); CAPUSSOTTI (Lorenzo); BÜCHLER (Markus W.); WEITZ (Jürgen)</AU>
<AF>Department of General, Visceral and Transplantation Surgery,University of Heidelberg/Allemagne (1 aut., 7 aut., 24 aut., 25 aut.); Department of Clinical & Surgical Sciences, University of Edinburgh/Edinburgh/Royaume-Uni (2 aut.); Department of Surgery, Flinders Medical Centre/Adelaide/Australie (3 aut.); Hepatopancreatobiliary and Transplant Surgery, Flinders Medical Centre/Adelaide/Australie (4 aut.); Hepatopancreatobiliary and Transplant Surgery,Royal Prince Alfred Hospital/Sydney/Australie (5 aut.); AP-HP Hôpital Paul Brousse,Centre Hépato-Biliaire/Villejuif/France (6 aut.); Department of Surgery, Hepato-Biliary-Pancreatic Surgery Division Graduate School of Medicine University of Tokyo/Tokyo/Japon (8 aut.); Department of Surgery,Memorial Sloan-Kettering Cancer Center/New York, NY/Etats-Unis (9 aut.); Department of Surgery,Melbourne University/Australie (10 aut., 19 aut.); Hepatobiliary Surgery,St Vincent's Hospital/Melbourne, Victoria/Australie (11 aut.); Department of Surgery,Alfred Hospital/Melbourne/Australie (12 aut.); Department of Surgery, Division of Surgical Oncology, Nagoya University Graduate School of Medicine/Nagoya/Japon (13 aut., 21 aut.); University of Adelaide Discipline of Surgery,The Queen Elizabeth Hospital/Woodville/Australie (14 aut.); Department of Gastrointestinal Surgery,Royal North Shore Hospital/Sydney/Australie (15 aut.); Department of Surgical Oncology,The University of Texas M. D. Anderson Cancer Center/Houston, TX/Etats-Unis (16 aut.); Department of Surgery,Toronto General Hospital, University of Toronto/Toronto/Canada (17 aut.); Department of Hepatobiliary Surgery,North Hampshire Hospital/Basingstoke/Royaume-Uni (18 aut.); Department of Surgery,Queen Mary Hospital, University of Hong Kong/Hong-Kong (20 aut.); Hepatobiliary and Pancreatic Division of Surgery,"Josep Trueta" Hospital, IDibGi, University of Girona/Crirona/Espagne (22 aut.); Division of Surgical Oncology,Institute of Cancer Research and Treatment/Candiolo, Turin/Italie (23 aut.)</AF>
<DT>Publication en série; Niveau analytique</DT>
<SO>Surgery; ISSN 0039-6060; Coden SURGAZ; Etats-Unis; Da. 2011; Vol. 149; No. 5; Pp. 713-724; Bibl. 79 ref.</SO>
<LA>Anglais</LA>
<EA>Background. Posthepatectomy liver failure is a feared complication after hepatic resection and a major cause of perioperative mortality. There is currently no standardized definition of Posthepatectomy liver failure that allows valid comparison of results from different studies and institutions. The aim of the current article was to propose a definition and grading of severity of posthepatectomy liver failure. Methods. A literature search on posthepatectomy liver failure after hepatic resection was conducted. Based on the normal course of biochemical liver function tests after hepatic resection, a simple and easily applicable definition of posthepatectomy liver failure was developed by the International Study Group of Liver Surgery. Furthermore, a grading of severity is proposed based on the impact on patients' clinical management. Results. No uniform definition of posthepatectomy liver failure has been established in the literature addressing hepatic surgery. Considering the normal postoperative course of serum bilirubin concentration and International Normalized Ratio, we propose definingposthepatectomy liver failure as the impaired ability of the liver to maintain its synthetic, excretory, and detoxifying functions, which are characterized by an increased international normalized ratio and concomitant hyperbilirubinemia (according to the normal łimits of the local laboratory) on or after postoperative day 5. The severity of posthepatectomy liver failure should be graded based on its impact on clinical management. Grade A posthepatectomy liver failure requires no change of the patient's clinical management. The clinical management of patients with grade B posthepatectomy liver failure deviates from the regular course but does not require invasive therapy. The need for invasive treatment defines grade C posthepatectomy liver failure. Conclusion. The current definition of posthepatectomy liver failure is simple and easily applicable in clinical routine. This definition can be used in future studies to allow objective and accurate comparisons of operative interventions in the field of hepatic surgery.</EA>
<CC>002B01; 002B13C03</CC>
<FD>Insuffisance hépatique; Définition; Grade histologique; Chirurgie; International; Monde; Foie; Médecine; Traitement</FD>
<FG>Pathologie de l'appareil digestif; Pathologie du foie; Appareil digestif</FG>
<ED>Liver failure; Definition; Histological grading; Surgery; International; World; Liver; Medicine; Treatment</ED>
<EG>Digestive diseases; Hepatic disease; Digestive system</EG>
<SD>Insuficiencia hepática; Definición; Grado histológico; Cirugía; Internacional; Mundo; Hígado; Medicina; Tratamiento</SD>
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<ID>11-0227318</ID>
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Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

Posthepatectomy liver failure: A definition and grading by the International Study Group of Liver Surgery (ISGLS)

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