Preoperative thrombocytopenia may predict poor surgical outcome after extended hepatectomy

Background:

It is a novel idea that platelet counts may predict the postoperative outcome following liver surgery. This may help in planning an extended hepatectomy (EH), which is a surgical procedure with high morbidity and mortality. The aim of this study was to evaluate the predictive potential of platelet counts on the outcome of EH.

Methods:

A series of 213 consecutive patients underwent EH (resection of ≥ five liver segments) between 2001 and 2016. The postoperative surgical outcomes were evaluated and compared between patients with a normal preoperative platelet count. The ability of preoperative platelet counts to predict posthepatectomy liver failure (PHLF), morbidity (based on Clavien-Dindo classification), and 30-day mortality was evaluated using multivariate analysis.

Results:

A total of 213 patients who underwent EH were included in our analyses. PHLF were detected in 26.3% of patients, complications in 45.5% of patients, and 30-day mortality in 11.3% of patients. Multivariate regression analysis revealed that the preoperative platelet count is an independent predictor of PHLF (odds ratio [OR] 4.4, 95% confidence interval [CI] 1.3 – 15.1, p= 0.019) and 30-day mortality (OR 6.3, 95% CI 1.4 – 27.9, p= 0.015).

Conclusions:

Preoperative platelet counts correlated with PHLF and mortality following extended liver resection. This predictive role was independent of other related parameters. Prospective studies are needed to further evaluate this predictive role and to determine the impact of preoperative correction of platelet count on postoperative outcomes after EH.