Simultaneous hepatectomy and ileostomy closure or bowel restoration increases risks of complications. A propensity-score matching analysis

Abstract

were assessed before and after each treatment and statistically evaluated. Results: 11 patients (median age 68; range 49e77) were included. MARS was started between POD 5 and 8 and a median of 5 treatments (range 5e7) were performed. No direct complication related to the MARS treatment was observed. Bilirubin decreased significantly from 126 mmol/ l (53e466) to 105 (23e324) (p < 0,01). INR decreased slightly but statistically not significant. Three patients with hepatic encephalopathy improved immediately after onset of MARS treatment so that, mechanical ventilation and parenteral nutrition could be avoided. 90-day mortality was 9% (1/11). Conclusion: The use of MARS in the PHLF situation is safe and feasible. Favorable effects of the treatment on clinical and laboratory parameters were observed. In addition, 90-day mortality was low compared to the estimated mortality according to the inclusion criteria (50:50 criteria).