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Posthepatectomy liver failure (PHLF) remains the most serious complication after liver resection, contributing substantially to perioperative morbidity and mortality. Numerous heterogeneous definitions had previously limited comparability across studies. The International Study Group of Liver Surgery (ISGLS) established a standardized definition and severity grading based on postoperative bilirubin and international normalized ratio dynamics from day 5 onward. This classification, stratifying PHLF into three grades according to clinical management requirements, has since been validated internationally and is now regarded as the reference standard. This chapter outlines the evolution of diagnostic criteria, the role of liver function tests and prediction models, and the clinical implications of the ISGLS definition, emphasizing its importance for outcome reporting and future research.

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Diagnosis and Classification of Posthepatectomy Liver Failure

  • 章节

  • 发表日期：

    2026年

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  • Emrullah Birgin,
  • Jan Heil,
  • Nuh N. Rahbari

摘要

Posthepatectomy liver failure (PHLF) remains the most serious complication after liver resection, contributing substantially to perioperative morbidity and mortality. Numerous heterogeneous definitions had previously limited comparability across studies. The International Study Group of Liver Surgery (ISGLS) established a standardized definition and severity grading based on postoperative bilirubin and international normalized ratio dynamics from day 5 onward. This classification, stratifying PHLF into three grades according to clinical management requirements, has since been validated internationally and is now regarded as the reference standard. This chapter outlines the evolution of diagnostic criteria, the role of liver function tests and prediction models, and the clinical implications of the ISGLS definition, emphasizing its importance for outcome reporting and future research.