2026-04-14T06:34:42Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/127072025-10-24T10:34:27Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Bouwense, Stefan
author
Bednarsch, Jan
author
Dewulf, Maxime
author
Kazemier, Geert
author
Maithel, Shishir
author
Olthof, Pim
author
Charco, Ramon
2025-10-24T10:34:27Z
2025-10-24T10:34:27Z
2025-03-07T10:34:30Z2025-03-07T10:34:30Z20242025-03
http://hdl.handle.net/11351/12707
Failure to rescue; Resection; Perhilar cholangiocarcinomaFracàs de rescat; Resecció; Colangiocarcinoma perhilarFracaso de rescate; Resección; Colangiocarcinoma perihiliarBackground
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.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
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
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion