Introduction Predicting the risk of post-operative complications following liver resection is an integral part of liver surgery planning. Post-operative liver function tests have been used for prediction of liver failure. We sought to clarify whether post-operative day 1 (POD-1) Alanine aminotransferase (ALT) was predictive of complications in a contemporary cohort of liver resections.
Method Interrogation of a prospectively maintained database from January 2013 to December 2014 was performed. POD-1 ALT was analysed against the occurrence of post-operative complications which were graded as per the Clavien-Dindo classification.
Results There were 114 liver resections; 4 patients were excluded as they underwent synchronous pancreas/liver surgery. There were 61 males (56%) and median patient age was 65 years. Sixty-nine (63%) resections were performed for colorectal liver metastases. Forty-two patients (38%) received neoadjuvant chemotherapy. There were 58 (52%) non-anatomical resections and 29 (26%) major hepatectomies. Forty-three (39%) patients had > 3 segments resected. The Pringle manoeuvre was used in 55 patients (50%) for a median (IQR) time of 18 (10–25) minutes. Intra-operative radiofrequency ablation (RFA) was employed as an adjunct to resection in 17 (16%) patients. Overall morbidity was 28% (n = 31) whereas mortality was 0.9% (n = 1). There were 16 Grade 2 (15%), 14 Grade 3 (13%) and no Grade 4 complications. Mean POD-1 ALT (IU/L) was significantly higher in the group of patients who underwent RFA (674 vs 330; p < 0.0001). POD-1 ALT was not statistically higher in the Pringle group (411 vs 353; p = 0.189). No significant increase in mean POD-1 ALT was seen in patients who had >grade 2 Clavien-Dindo complications (450 vs 357; p = 0.585).
Conclusion Our data shows that POD-1 ALT does not reliably predict the occurrence of post-operative complications after liver resection.
Disclosure of interest None Declared.
Statistics from Altmetric.com
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.