The Association Between Low Preoperative Phosphate Levels and Postliver Surgery Outcomes- a Single Center Experience

J Surg Res. 2024 May 16:299:145-150. doi: 10.1016/j.jss.2024.04.027. Online ahead of print.

Abstract

Introduction: Previous research has demonstrated the impact of postoperative phosphate levels on liver regeneration and outcomes after liver resection surgeries, a potential predictor for regenerative success and liver failure. However, little is known about the association between low preoperative serum phosphate levels and outcomes in liver resections.

Methods: We performed a retrospective analysis of liver resections performed at our institution. Patients were categorized based on preoperative phosphate levels (low versus normal). Our primary outcome measure was posthepatectomy liver failure.

Results: A total of 265 cases met the study criteria. 71 patients (26.7%) had low preoperative phosphate levels. The incidence of posthepatectomy liver failure was higher in the low preoperative phosphate group (19.2% versus 12.4%). However, after propensity score matching, rates of posthepatectomy liver failure were similar between low and normal preoperative phosphate cohorts (13% versus 14%, P = 0.83).

Conclusions: Low preoperative phosphate levels were not associated with worse postoperative outcomes in this study. Further studies are warranted to investigate this association and its relevance as a clinical prognostic factor for postoperative liver failure.

Keywords: Liver regeneration; Liver resection; Posthepatectomy liver failure; Preoperative hypophosphatemia; Surgical outcomes.