The incidence of a marginal ulcer perforating after LRYGB was significant (>1%) and appeared to be related to smoking or the use of NSAIDs or steroids. Because only 0.2% of all patients acutely perforated without some risk factor or warning, long-term ulcer prophylaxis or treatment may be necessary for only a select group of high-risk patients.
Key Points
Question
Are the noninvasive fibrosis markers aspartate aminotransferase–platelet ratio index and fibrosis 4 associated with perioperative mortality and overall survival after hepatectomy for hepatocellular carcinoma?
Findings
In this cohort study of 475 US veterans, aspartate aminotransferase–platelet ratio index and fibrosis 4 were independently associated with increased 30- and 90-day mortality and worse overall survival. They were shown to improve the estimation of postoperative mortality.
Meaning
This study suggests that the incorporation of aspartate aminotransferase–platelet ratio index and fibrosis 4 in the selection criteria of hepatectomy for hepatocellular carcinoma may be warranted.
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