How good laparoscopic liver resections are? a propensity score-matched analysis of perioperative outcomes

Abstract

Background and aims: Previously, modification of intraplatelet serotonin was hypothesized as a potential intervention to improve liver regeneration in patients undergoing liver resection. However, within a recent study our group showed a potential adverse effect of high intra-platelet serotonin in terms of oncologic outcome. Within this study, exploratory data on the use of selective serotonin reuptake inhibitors (SSRI) was collected. Still, the number of patients with SSRI therapy was limited. Thus, we now aimed to evaluate the use of selective serotonin reuptake inhibitors (SSRI) in a large cohort of patients undergoing liver resection. Methods: 333 patients were included out of our prospectively maintained institutional data base. Intake of SSRI during the perioperative period was recorded. Patients were followed up for postoperative liver dysfunction (LD) and morbidity. Results: In total, 37 patients (9.1%) were perioperatively treated with SSRI. Patients with SSRI intake showed a higher incidence of morbidity (40.9% in no SSRI vs 48.6% in SSRI, p=NS) and a significantly increased incidence of LD (10.5% in no SSRI vs 21.6% in SSRI, p=0.047). Ultimately, logistic regression analysis was computed and showed a significantly increased risk for postoperative LD in patients using SSRI (p=0.039,OR=2.939). Conclusion: The present study is the first one to present solid data on an association between SSRI intake and poor postoperative outcome in patients undergoing liver resection. This association might be due to an impairment of liver regeneration as a result from decreased intra-platelet levels of serotonin.