Preoperative Serum Bilirubin and Lactate Levels Predict Postoperative Morbidity and Mortality in Liver Surgery: A Single-Center Evaluation

Scand J Surg. 2015 Sep;104(3):176-84. doi: 10.1177/1457496914548093. Epub 2014 Sep 17.


Background and aims: In spite of huge developments in liver surgery during the last decades, morbidity and mortality continue to pose problems in this field. The aim of this study was to identify preoperative predictors for postoperative mortality and morbidity in liver surgery.

Material and methods: In a single-center study, an extensive analysis of a prospective database, including clinical criteria and laboratory tests of patients undergoing liver surgery between July 2007 and July 2012 was performed. Cutoff values of selected laboratory tests were calculated.

Results: In all, 337 patients were included in the study. Univariate analysis showed a statistically significant association of preoperative bilirubin, lactate, hemoglobin levels, platelet count, and prothrombin time with postoperative morbidity and mortality. Multivariate analysis revealed preoperatively elevated serum bilirubin and lactate levels as independent predictors for increased postoperative morbidity and mortality after liver surgery.

Conclusions: The identified laboratory values showed a statistically significant association with postoperative morbidity and mortality in liver surgery and might be helpful in preoperative patient selection.

Keywords: Liver surgery; bilirubin; lactate; postoperative morbidity; postoperative mortality; preoperative predictors.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Bilirubin / blood*
  • Cohort Studies
  • Female
  • Hepatectomy / adverse effects*
  • Hepatectomy / mortality
  • Humans
  • Lactic Acid / blood*
  • Liver Diseases / blood*
  • Liver Diseases / mortality*
  • Liver Diseases / surgery
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Treatment Outcome
  • Young Adult


  • Lactic Acid
  • Bilirubin