Marie Wieser, Chetana Lim, Claire Goumard, Olivier Soubrane, Louise Barbier, Jean-Marc Regimbeau, Christian Hobeika, Alexis Laurent, David Fuks, Laurence Chiche, Michel Rayar, Francis Navarro, Patrick Pessaux, Antonio Sa Cunha, Eric Vibert, Olivier Scatton
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Laparoscopic liver resection in high-risk anesthesia patients A French nationwide study.
Background: Studies evaluating the impact of the American Society of Anesthesiologists Physical status (ASA-PS) score on outcomes after liver resection (LR) are currently lacking. The aim was to evaluate the value of ASA-PS score on perioperative outcomes for laparoscopic liver resection (LLR).
Methods: This is a retrospective analysis of patients who underwent LLR from 1996 to 2018 at 29 French medical centers. High-risk anesthesia patients were defined as those with ASA-PS scores ≥3. Postoperative outcomes including 90-day mortality, morbidity and failure to rescue (death within 90 days following any major postoperative complication) were compared between high- and low-risk anesthesia patients.
Results: Of 3154 patients included, 734 (23.3 %) had ASA-PS scores ≥3. The 90-day mortality (2.6 % vs. 0.6 %), overall morbidity (42.0 % vs. 33.8 %), severe morbidity (11.2 % vs. 7.4 %) and failure to rescue (23.2 % vs. 7.9 %) rates were higher in the ASA-PS score ≥3 group (all p < 0.05). In the multivariable analysis, ASA-PS score ≥3 was an independent risk factor for failure to rescue after LLR in the study population.
Conclusion: LLR in high-ASA patients can be performed with a higher rate of mortality and morbidity.
期刊介绍：
HPB is an international forum for clinical, scientific and educational communication.
Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice.
Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice.
HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields.
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HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).
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