Postoperative collections after liver surgery: Risk factors and impact on long-term outcomes

Area of Science:

• Hepatobiliary Surgery
• Surgical Oncology
• Abdominal Imaging

Background:

• Postoperative collections (PC) are a known complication after liver surgery, but their impact on patient outcomes remains under-investigated.
• Understanding factors predicting PC occurrence and drainage is crucial for optimizing patient management.

Purpose of the Study:

• To identify predictors of postoperative collection (PC) occurrence after liver surgery.
• To determine factors associated with the need for drainage.
• To evaluate the impact of PC on oncologic outcomes and overall survival.

Main Methods:

• Single-center cohort study including adult patients undergoing liver surgery from 2008 to 2017.
• Primary objective: identify variables associated with PC occurrence (defined by CT scan on postoperative day 7).
• Secondary objectives: factors predicting drainage and overall survival predictors.

Main Results:

• 53.6% of 395 patients developed PC; 12% required drainage.
• Predictors for PC included BMI > 35 kg/m² and major liver surgery extent; laparoscopic approach showed a protective effect.
• PC requiring treatment correlated with long-term mortality in patients with malignant disease.

Conclusions:

• Major open liver surgery in patients with BMI > 35 kg/m² increases PC risk, warranting systematic postoperative imaging.
• Drainage decisions for PC should be guided by clinical symptoms.
• Treated PCs negatively impact overall survival in patients with malignancies.