Dataset Information

E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy.

ABSTRACT:

Background

Posthepatectomy liver failure (PHLF) contributes significantly to morbidity and mortality after liver surgery. Standardized assessment of preoperative liver function is crucial to identify patients at risk. These European consensus guidelines provide guidance for preoperative patient assessment.

Methods

A modified Delphi approach was used to achieve consensus. The expert panel consisted of hepatobiliary surgeons, radiologists, nuclear medicine specialists, and hepatologists. The guideline process was supervised by a methodologist and reviewed by a patient representative. A systematic literature search was performed in PubMed/MEDLINE, the Cochrane library, and the WHO International Clinical Trials Registry. Evidence assessment and statement development followed Scottish Intercollegiate Guidelines Network methodology.

Results

Based on 271 publications covering 4 key areas, 21 statements (at least 85 per cent agreement) were produced (median level of evidence 2- to 2+). Only a few systematic reviews (2++) and one RCT (1+) were identified. Preoperative liver function assessment should be considered before complex resections, and in patients with suspected or known underlying liver disease, or chemotherapy-associated or drug-induced liver injury. Clinical assessment and blood-based scores reflecting liver function or portal hypertension (for example albumin/bilirubin, platelet count) aid in identifying risk of PHLF. Volumetry of the future liver remnant represents the foundation for assessment, and can be combined with indocyanine green clearance or LiMAx® according to local expertise and availability. Functional MRI and liver scintigraphy are alternatives, combining FLR volume and function in one examination.

Conclusion

These guidelines reflect established methods to assess preoperative liver function and PHLF risk, and have uncovered evidence gaps of interest for future research.

SUBMITTER: Primavesi F

PROVIDER: S-EPMC10480040 | biostudies-literature | 2023 Sep

REPOSITORIES: biostudies-literature

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Publications

E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy.

Primavesi Florian F Maglione Manuel M Cipriani Federica F Denecke Timm T Oberkofler Christian E CE Starlinger Patrick P Dasari Bobby V M BVM Heil Jan J Sgarbura Olivia O Søreide Kjetil K Diaz-Nieto Rafael R Fondevila Constantino C Frampton Adam E AE Geisel Dominik D Henninger Benjamin B Hessheimer Amelia J AJ Lesurtel Mickaël M Mole Damian D Öllinger Robert R Olthof Pim P Reiberger Thomas T Schnitzbauer Andreas A AA Schwarz Christoph C Sparrelid Ernesto E Stockmann Martin M Truant Stéphanie S Aldrighetti Luca L Braunwarth Eva E D'Hondt Mathieu M DeOliveira Michelle L ML Erdmann Joris J Fuks David D Gruenberger Thomas T Kaczirek Klaus K Malik Hassan H Öfner Dietmar D Rahbari Nuh N NN Göbel Georg G Siriwardena Ajith K AK Stättner Stefan S

The British journal of surgery 20230901 10

<h4>Background</h4>Posthepatectomy liver failure (PHLF) contributes significantly to morbidity and mortality after liver surgery. Standardized assessment of preoperative liver function is crucial to identify patients at risk. These European consensus guidelines provide guidance for preoperative patient assessment.<h4>Methods</h4>A modified Delphi approach was used to achieve consensus. The expert panel consisted of hepatobiliary surgeons, radiologists, nuclear medicine specialists, and hepatolog ...[more]

PMID: 37572099

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Dataset Information

E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy.

Background

Methods

Results

Conclusion

Publications

E-AHPBA-ESSO-ESSR Innsbruck consensus guidelines for preoperative liver function assessment before hepatectomy.

Similar Datasets

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