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2016 ; 5
(3
): 217-24
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Hypophosphatemia and recovery of post-hepatectomy liver insufficiency
#MMPMID27275463
Hallet J
; Karanicolas PJ
; Zih FS
; Cheng E
; Wong J
; Hanna S
; Coburn NG
; Law CH
Hepatobiliary Surg Nutr
2016[Jun]; 5
(3
): 217-24
PMID27275463
show ga
BACKGROUND: Hypophosphatemia (HP) is frequent following liver resection, and
thought to represent use of phosphate during liver regeneration. We sought to
evaluate the association of post-hepatectomy HP with liver insufficiency and
recovery. METHODS: Liver resections were retrospectively reviewed from 2009 to
2012 at a single institution. We explored the relationship between HP (defined as
serum phosphate ?0.65 mmol/L), occurrence of initial liver insufficiency (ILI)
[bilirubin >50 µmol/L, international normalized ratio (INR) >1.7 within 72 hours
of surgery] and in-hospital recovery of ILI. Secondary outcomes included 30-day
post-operative major morbidity (Clavien grade 3 and 4 complications), mortality,
and re-admission. RESULTS: Among 402 patients, 223 (55.5%) experienced HP and 64
(15.9%) met our definition of ILI, of which 53 (82.8%) recovered. Length of stay,
30-day post-operative major morbidity, mortality, and re-admission were similar
between patients with and without HP. Among patients with ILI, 44 (68.8%)
experienced HP. Following ILI, patients with HP recovered more often than those
with NP (90.9% vs. 65.0%; P=0.03). CONCLUSIONS: In patients who experience
post-hepatectomy ILI, HP is associated with improved recovery, potentially
indicating more efficient liver regeneration. Further studies should explore the
usefulness of post-hepatectomy HP as an early prognostic factor of recovery from
ILI.