“…Mechanisms underlying the negative influence of severe SD on major morbidity are unknown, although preoperative hepatic dysfunction, impairment of liver regeneration, Kupffer cell dysfunction, enhanced blood loss due to haemorrhagic pools, fragility of the liver, and increased hepatocellular necrosis as seen in human and animal models, can all be reasons for poor liver function and an increased complication rate after severe SD. However, as the P value was of borderline significance, the effect of severe SD on major morbidity must be interpreted with caution.…”