Is conventional functional liver remnant volume higher than 40% still sufficient to prevent post‐hepatectomy liver failure in jaundiced patients with hilar cholangiocarcinoma? A single‐center experience in China

Abstract Objective Our study aims to evaluate the predictive accuracy of functional liver remnant volume (FLRV) in post‐hepatectomy liver failure (PHLF) among surgically‐treated jaundiced patients with hilar cholangiocarcinoma (HCCA). Methods We retrospectively reviewed surgically‐treated jaundiced patients with HCCA between June, 2000 and June, 2018. The correlation between FRLV and PHLF were analyzed. The optimal cut off value of FLRV in jaundiced HCCA patients was also identified and its impact was furtherly evaluated. Results A total of 224 jaundiced HCCA patients who received a standard curative resection (43 patients developed PHLF) were identified. Patients with PHLF shared more aggressive clinic‐pathological features and were generally in a more advanced stage than those without PHLF. An obvious inconsistent distribution of FLRV in patients with PHLF and those without PHLF were detected. FLRV (continuous data) had a high predictive accuracy in PHLF. The newly‐acquired cut off value (FLRV = 53.5%, sensitivity = 81.22%, specificity = 81.4%) showed a significantly higher predictive accuracy than conventional FLRV cut off value (AUC: 0.81 vs. 0.60, p