Figure Forrest Plot postoperative morbidity TP23 - Talking Poster Session 23 - Liver: Surgical Outcomes 2 TP23-01 MINOR LAPAROSCOPIC LIVER RESECTION AS DAY-CASE SURGERY (WITHOUT OVERNIGHT HOSPITALIZATION): A PILOT STUDY L. Rebibo 1 , P. Leourier 1 , R. Badaoui 2 , F. Le Roux 1 , E. Lorne 2 and J. -M. Regimbeau 1 1 DIgestive Surgery, and 2 Anesthesiology, Universitary Hospital of Amiens, France Introduction: Day-case surgery (DCS) has boomed over recent years, as has laparoscopic liver resection (LLR) for the treatment of liver tumor (benign or malign). The pur- pose of this prospective study was to show the feasibility of minor LLR as DCS. Material and methods: This was a prospective, intention to treat, non-randomized study of consecutive patients un- dergoing minor LLR from July 2015 to December 2017. Exclusion criteria were liver resection using laparotomy, major LLR, difficult locations for minor LLR, major abdominal surgery using laparotomy, hepatobiliary pro- cedures without liver parenchyma resection, cirrhosis with Child >A and/or portal hypertension, presence of a sig- nificant medical history and exclusion criteria for DCS. Primary endpoint was the unplanned overnight admission rate. Secondary endpoints were criteria for DCS evaluation, satisfaction and compliance to the protocol. Results: During the study period, 167 patients underwent liver resection. On this population, 23 (25%) were included as DCS. Causes for minor LLR were liver metastasis (n=9), hepatic adenoma (n=5), hepatocellular carcinoma (n=4), ciliated hepatic foregut cyst (n=2) and other benign tumors (n=3). All day-case minor LLR excepted two patients consisted of single wedge resection and one patient had left lateral sectionectomy. There were four unplanned over- night admissions (17.4%). There were one unexpected consultations (4.3%), two hospital readmissions (8.6%) and no major complications or mortality. Compliance to the protocol was 69.5%. Satisfaction rate was 91%. Conclusion: In selected patients, day-case minor LLR is feasible and has acceptable complication and readmission rates. Hence, day-case minor LLR can be legitimately implemented for selected patients. TP23-02 TOWARDS SAFER LIVER RESECTION D. Sidorov, M. Lozhkin, L. Petrov and A. Isaeva Abdominal Surgery, Moscow Oncology Research Institute n.a. P.A. Hertsen, Russian Federation Introduction: This study aimed to assess the value of preoperative assessment of liver function (LF) using ICG- test, methacetin breath test and 99mTc-technephyt hepa- tobiliary scintigraphy( HBS) to predict postop liver failure. Method: 150 patients with primary and metastatic liver tumors who underwent major liver resection between 2012 and 2017 were included. All patients have passed standard clinical and lab-tests (the values of TB, ALB and PT showed no decrease in LF), CT-volumetry. ICG-test, methacetin breath test and 99mTc-HBS were performed prior to major resection for 60 patients(study group). Postop liver failure was established based on 50/50-criteria when evaluated on the 5th-postoperative day. The cut-off value for the predic- tion of liver failure was calculated using the ROC-analysis. Results: ROC-values for the postop liver failure prediction were 0.89, 0.78, 0.69 for methacetin breath test, HBS, ICG- test and 0.65 for FLR volume respectively. In conformity with functional tests results SVI-SVII and SV-SVIII bisegmentectomy was performed instead of right hemi- hepatectomy in 33,2% cases. In 15 patients (25%) surgical approach was revised for two-stage or ALPPS resection An incidence of post-resection acute liver failure by 50-50 criteria in the study group was significantly 2.1-fold lower 7.1% vs 15.3%, respectively (p < 0.001). Conclusions: Assessment of liver function had better pre- dictive value for liver failure than liver volume in patients undergoing major liver resection for malignant liver tu- mours. Preop evaluation of liver function is important not only in order to detect patients at risk of developing liver failure after liver resection but also for tailoring the appropriate extent of resection. TP23-03 PROLONGED HYPERCOAGULABILITY FOLLOWING MAJOR LIVER RESECTION FOR MALIGNANCY M. E. Tun Abraham 1 , N. Sela 2 , C. Garcia-Ochoa 2 , H. Sharma 1,3 , I. Al-Hasan 1,4 , A. Dhir 5 , F. Ralley 5 , D. Quan 1 , A. Skaro 1 and R. Hernandez-Alejandro 1,6 1 HPB & Multiorgan Transplantation, 2 General Surgery, 3 Multiorgan Transplantation, Ochsner, United States, 4 HPB & Multiorgan Transplantation, Prince Sultan Mili- tary Medical City, Saudi Arabia, 5 Anesthesia, Western University, Canada, and 6 Multiorgan Transplantation, University of Rochester, United States Hypercoagulability is a common manifestation of ma- lignancy particularly in the setting of hepatic oligometa- stases. Major liver resection and hepatic regeneration have a profound and variable impact on coagulation. The need for and duration of venous thromboembolism (VTE) chemoprophylaxis remains uncertain. Rotational throm- boelastometry (ROTEM) was used to augment standard coagulation testing (SCT) to characterize hypercoagula- bility following major liver resection A prospective cohort study of thirty patients undergoing major liver resection (>3 segments) for malignancy from 2015e2017 was performed. Pre- and post-operative (days 1, 3, 5, 7, and 4 weeks) coagulation profiles were evaluated using SCT and ROTEM. Hypercoagulability was defined by ROTEM (Clotting-Formation-Time >98sec; Maximum- Clot-firmness >68mm) or SCT (platelets >450,000); fibrinogen >4.3). ROC curves were constructed to assess diagnostic accuracy of SCT and ROTEM. HPB 2018, 20 (S2), S295eS332 S330 “Talking Posters” (TP01-TP24)