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Published on: December 4, 2023
Laparoscopic liver resection in high-risk anesthesia patients A French nationwide study
Marie Wieser1, Chetana Lim2, Claire Goumard3
1Sorbonne Université, Department of Hepato-Pancreato-Biliary Surgery and Liver Transplantation, AP-HP Pitié-Salpêtrière Hospital, Paris, France.
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.
