The role of the AST-to-platelet ratio index (APRI) score on outcomes following robotic minor, technically major, & major hepatectomy for liver tumors.

Predictive capability of aspartate transaminase-to-platelet ratio index (APRI) in assessing liver fibrosis/cirrhosis. This study aims to evaluate the correlation between APRI scores and perioperative outcomes following robotic hepatectomy. Data of 530 consecutive patients undergoing robotic hepatectomy were analyzed. Patients were classified based on an APRI score threshold of 0.7 and extent of resection. Data are presented as median (mean ± SD). Of 530 patients, 166 (31%) underwent major resection. Expectedly, major resections were associated with higher expert-level operations based on IWATE system. While having statistically similar APRI scores, patients undergoing major resection had larger tumor size (p = 0.003), longer operative duration (p < 0.0001), and higher blood loss (p = 0.0002). Patients undergoing minor/technically major resections, 100 (27%) patients had an elevated APRI, which was associated with higher MELD score (p = 0.0001), Child-Pugh score (p = 0.0001), cirrhosis (p < 0.0001), and neoplastic diseases (p < 0.0001). Patients undergoing major resections, 48 (29%) had elevated APRI, which was also associated with higher Child-Pugh Score (p < 0.0001), cirrhosis (p = 0.0008), and neoplastic diseases (p = 0.001). Elevated APRI levels were indicative of cirrhosis and higher MELD score; however, outcomes following robotic major hepatectomy remain unaffected by the index.