Impact of aortic calcification at the origin of celiac artery on post-operative outcomes of major hepatectomy: A significant risk factor for posthepatectomy liver failure.

Purpose: Aortic calcification is associated with arteriosclerosis and is often seen in patients undergoing hepatectomy. However, its impact on post-operative outcomes after major hepatectomy is still unclear.

Methods: From July, 2015 to December, 2022, 127 patients who underwent resection of three or more adjacent liver segments (major hepatectomy) were retrospectively reviewed. Aortic calcification at the origin of celiac artery was assessed on pre-operative abdominal CT scan images. pPerioperative factors and postoperative outcomes were compared between patients with and without aortic calcification. Uni-variable and multi-variable analyses were performed to identify risk factors of posthepatectomy liver failure (PHLF).

Results: Aortic calcification at the origin of celiac artery was observed in 62 (48.8%) of 127 patients. Those with aortic calcification were significantly older and had a higher incidence of hypertension, as a comorbidity, compared to those without. Furthermore, incidences of both post-operative liver failure and other complications were significantly higher among patients with aortic calcification, who also had a longer hospital stay. Multivariable logistic analysis identified aortic calcification and longer operation time as independent risk factors of PHLF. Additionally, stenosis of the celiac artery also impacted the development of PHLF.

Conclusion: These findings indicate that aortic calcification at the origin of celiac artery is associated with advanced age and may be a risk factor of PHLF following major hepatectomy.