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<p>Multimorbidity is characterized by the presence of at least 3 chronic diseases with a&#xa0;prevalence of more than 50% of patients over 60&#xa0;years old. The Charlson comorbidity index (CCI) enables a&#xa0;description of the severity of the multimorbidity and also provides a&#xa0;correlation with the postoperative outcome after liver resection. According to this, multimorbid patients are at increased risk of morbidity and mortality after liver resection, mostly due to postoperative liver failure. In particular, open major liver resection with biliary reconstruction and primary liver tumors linked to metabolic associated fatty liver disease (MAFLD) pose an increased risk for multimorbid patients. In contrast, minimally invasive resection leads to a&#xa0;clear reduction in postoperative morbidity and mortality. Preconditioning of the liver and the implementation of perioperative strategies according to the enhanced recovery after surgery (ERAS) concept can also lead to an improvement of the postoperative outcome.</p>

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Multimorbidität in der Leberchirurgie

  • 期刊论文

  • 发表日期：

    2025年1月8日

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  • Emrullah Birgin,
  • Jan Heil,
  • Elisabeth Miller,
  • Marko Kornmann,
  • Nuh N. Rahbari

摘要

Multimorbidity is characterized by the presence of at least 3 chronic diseases with a prevalence of more than 50% of patients over 60 years old. The Charlson comorbidity index (CCI) enables a description of the severity of the multimorbidity and also provides a correlation with the postoperative outcome after liver resection. According to this, multimorbid patients are at increased risk of morbidity and mortality after liver resection, mostly due to postoperative liver failure. In particular, open major liver resection with biliary reconstruction and primary liver tumors linked to metabolic associated fatty liver disease (MAFLD) pose an increased risk for multimorbid patients. In contrast, minimally invasive resection leads to a clear reduction in postoperative morbidity and mortality. Preconditioning of the liver and the implementation of perioperative strategies according to the enhanced recovery after surgery (ERAS) concept can also lead to an improvement of the postoperative outcome.