2026-04-14T07:43:49Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/127072025-10-24T10:34:27Zcom_2072_378070com_2072_378040col_2072_378092

00925njm 22002777a 4500 dc Bouwense, Stefan author Bednarsch, Jan author Dewulf, Maxime author Kazemier, Geert author Maithel, Shishir author Olthof, Pim author Charco, Ramon author 2025-03-07T10:34:30Z 2025-03-07T10:34:30Z 2024 2025-03 Failure to rescue; Resection; Perhilar cholangiocarcinoma Fracàs de rescat; Resecció; Colangiocarcinoma perhilar Fracaso de rescate; Resección; Colangiocarcinoma perihiliar Background Failure to rescue (FTR) is defined as the inability to prevent death after the development of a complication. FTR is a parameter in evaluating multidisciplinary postoperative complication management. The aim of this study was to evaluate FTR rates after major liver resection for perihilar cholangiocarcinoma (pCCA) and analyze factors associated with FTR. Patients and Method Patients who underwent major liver resection for pCCA at 27 centers were included. FTR was defined as the presence of a Dindo grade III or higher complication followed by death within 90 days after surgery. Liver failure ISGLS grade B/C were scored. Multivariable logistic analysis was performed to identify predictors of FTR and reported using odds ratio and 95% confidence intervals. Results In the 2186 included patients, major morbidity rate was 49%, 90-day mortality rate 13%, and FTR occurred in 24% of patients with a grade III or higher complication. Across centers, major complication rate varied from 19 to 87%, 90-day mortality rate from 5 to 33%, and FTR ranged from 11 to 50% across hospitals. Age [1.04 (1.02–1.05) years], ASA 3 or 4 [1.40 (1.01–1.95)], jaundice at presentation [1.79 (1.16–2.76)], right-sided resection [1.45 (1.06–1.98)], and annual hospital volume < 6 [1.44 (1.07–1.94)] were positively associated with FTR. When liver failure is included, the odds ratio for FTR is 9.58 (6.76–13.68). Conclusion FTR occurred in 24% of patients after resection for pCCA. Liver failure was associated with a nine-fold increase of FTR and hospital volume below six was also associated with an increased risk of FTR. http://hdl.handle.net/11351/12707 Conductes biliars - Càncer - Cirurgia - Complicacions Avaluació de resultats (Assistència sanitària) Conductes biliars - Càncer - Prognosi Insuficiència hepàtica DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Glandular and Epithelial::Carcinoma::Adenocarcinoma::Cholangiocarcinoma Other subheadings::Other subheadings::Other subheadings::/surgery DISEASES::Pathological Conditions, Signs and Symptoms::Pathologic Processes::Postoperative Complications DISEASES::Neoplasms::Neoplasms by Site::Digestive System Neoplasms::Biliary Tract Neoplasms::Bile Duct Neoplasms ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Treatment Outcome::Treatment Failure::Failure to Rescue, Health Care DISEASES::Digestive System Diseases::Liver Diseases::Hepatic Insufficiency ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias glandulares y epiteliales::carcinoma::adenocarcinoma::colangiocarcinoma Otros calificadores::Otros calificadores::Otros calificadores::/cirugía ENFERMEDADES::afecciones patológicas, signos y síntomas::procesos patológicos::complicaciones posoperatorias ENFERMEDADES::neoplasias::neoplasias por localización::neoplasias del sistema digestivo::neoplasias del tracto biliar::neoplasias de los conductos biliares TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::resultado del tratamiento::fracaso del tratamiento::fallo de rescate en la atención a la salud ENFERMEDADES::enfermedades del sistema digestivo::enfermedades hepáticas::insuficiencia hepática Failure to Rescue After Resection of Perhilar Cholangiocarcinoma in an International Multicenter Cohort