Liver surgery-specific complications are an independent factor influencing long-term survival following major hepatectomy. Issue 10 (October 2021)

• Record Type: Journal Article
• Authors: Kemper, Marius; Heumann, Asmus; Freiwald-Bibiza, Eric; Stüben, Björn-Ole; Izbicki, Jakob R.; Li, Jun
• Is Part Of: HPB. Volume 23:Issue 10(2021)
• Page Start: 1496
• Page End: 1505
• Publication Date: 2021-10
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2021.02.013
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: 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.