ArticleJournal of the American College of Surgeons2026
Establishing the Minimum Future Liver Remnant Volume for Safe Hepatectomy.
Article in Journal of the American College of Surgeons, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
2 citing papers in PubMed.
- Article
- ALPPS for perihilar cholangiocarcinoma in a patient with cirrhosis and cardiopulmonary comorbidities: a case report.International journal of surgery case reports · 2026Article
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Authors and funding
10 authors.
Funding
Abstract
backgroundAn adequate future liver remnant volume (FLRV%) reduces the risk of posthepatectomy liver failure (PHLF). This study evaluates (1) the association of FLRV% with grade 4/5 morbidity and (2) the safe FLRV% threshold for PHLF- and non-PHLF-related major morbidity. STUDY
designPatients undergoing major hepatectomy for malignancy from 2000 to 2020 were included. FLRV%, morbidity, and cause (PHLF- or non-PHLF-related) were determined; patients were stratified by normal livers (NLs) or impaired livers (ILs). The relationship between FLRV% and both all-cause and PHLF-related grade 4 or 5 morbidity was analyzed. The data were then randomly divided into training and testing cohorts to validate a safe FLRV% threshold.
resultsA total of 1,748 patients were included: 70% had metastatic liver cancer, and 42% underwent right hepatectomy. Median FLRV% was 42% (range 16% to 90%). Overall morbidity was 51%. Grade 4/5 morbidity was 3.2%: 28 (50%) PHLF-related, and of these, 26 (26 of 28; 92.9%) were fatal. There was a significant association between FLRV% and grade 4/5 PHLF-related morbidity. For every 10% increase in FLRV%, the odds of grade 4/5 PHLF-related morbidity decreased by nearly 40% after adjusting for age and functional liver status (odds ratio 0.61, 95% CI 0.45 to 0.84, p = 0.002). Conversely, there was no significant association between FLRV% and non-PHLF-related grade 4/5 morbidity (odds ratio 0.95, 95% CI 0.74 to 1.21, p = 0.65). FLRV% of ≥30% in NL and ≥50% in the IL group were established as safe minimum thresholds.
conclusionsThere was a close correlation between grade 4/5 PHLF-related morbidity and FLRV%, but the safe limit of resection was dependent on the liver remnant quality (>30% NL, >50% IL). By contrast, 50% of all grade 4 and 5 morbidities was unrelated to PHLF and not influenced by FLRV%.
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