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Liver stiffness measurement predicts high‐grade post‐hepatectomy liver failure: A prospective cohort study
Author(s) -
Chong Charing ChingNing,
Wong Grace LaiHung,
Chan Anthony WingHung,
Wong Vincent WaiSun,
Fong Anthony Kwongwai,
Cheung YueSun,
Wong John,
Lee KitFai,
Chan Stephen L,
Lai Paul BoSan,
Chan Henry LikYuen
Publication year - 2017
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.13503
Subject(s) - medicine , hepatectomy , transient elastography , cirrhosis , hepatocellular carcinoma , receiver operating characteristic , prospective cohort study , cohort , gastroenterology , surgery , liver fibrosis , resection
Background and Aim Liver stiffness measurement using transient elastography appears to be an excellent tool for detection of liver fibrosis and cirrhosis with high accuracy. The aim of this study is to evaluate the efficacy of preoperative liver stiffness measurement in predicting post‐hepatectomy liver failure. Methods A prospective cohort study of all consecutive patients undergoing hepatectomy for hepatocellular carcinoma from February 2010 to August 2014 was studied. All patients received detailed preoperative assessments including liver stiffness measurement. The primary outcome was post‐hepatectomy liver failure according to the International Study Group of Liver Surgery definition. Results A total of 255 patients were included. Liver stiffness measurement showed significant correlation with grade B or C post‐hepatectomy liver failure. ( P = 0.003) Using the cutoff at 12 kPa, liver stiffness measurement had a sensitivity of 52.4% and specificity of 73.3% in predication of high‐grade (grade B or C) post‐hepatectomy liver failure. Liver stiffness measurement > 12 kPa was also an independent prognostic factor for both high‐grade post‐hepatectomy liver failure and major postoperative complications by multivariate analysis. The diagnostic accuracy was better in patients without right lobe tumor with an area under the receiver operating characteristic of 0.83 compared with an area under the receiver operating characteristic of only 0.62 in patients with right lobe tumor. Conclusions Liver stiffness measurement using Fibroscan is good to predict high‐grade post‐hepatectomy liver failure especially in patients without right lobe tumor.