Intraoperative Continuous Terlipressin Infusion is Associated With Reduced Severe Postoperative Complications After Laparoscopic Hepatectomy: a Prospective Propensity Score-matched Cohort Study

Liver resection is an important surgical treatment for patients with liver diseases. Despite advances in surgical and anesthetic management, postoperative complications remain a major concern and may affect patient recovery. Maintaining stable blood circulation during surgery is an important part of perioperative care. Terlipressin is a vasoactive medication that may help maintain blood pressure and improve hemodynamic stability during surgery. However, the relationship between intraoperative continuous terlipressin infusion and postoperative outcomes after laparoscopic hepatectomy remains unclear. This prospective observational cohort study aims to evaluate the association between continuous intraoperative terlipressin infusion and postoperative severe complications in patients undergoing laparoscopic hepatectomy. Patients undergoing laparoscopic hepatectomy at the First Affiliated Hospital of Sun Yat-sen University will be enrolled and followed according to a predefined study protocol. Perioperative clinical information, anesthetic management data, terlipressin exposure, and postoperative outcomes will be collected and analyzed. The primary outcome is the occurrence of severe postoperative complications, defined as Clavien-Dindo grade III or higher complications.

Inclusion Criteria: * Eligible participants were adults aged 18 to 80 years, classified as American Society of Anesthesiologists (ASA) physical status I-III, who were scheduled for elective laparoscopic partial hepatectomy and provided written informed consent. Exclusion Criteria: * Key exclusion criteria included: pre-anesthetic assessment indicating intolerance to the procedure; severe hepatic (Child-Pugh class B or higher) or renal dysfunction (blood urea nitrogen \> 9 mmol/L or serum creatinine \> 178 μmol/L); significant cardiovascular or cerebrovascular disease, such as active coronary artery disease, severe valvular stenosis, hypertrophic obstructive cardiomyopathy, or a history of extensive cerebral infarction; known allergy to any study medication; a body mass index (BMI) \> 35 kg/m² or \< 18 kg/m²; a hemoglobin (Hb) level \< 90 g/L; pregnancy or lactation; participation in another clinical trial within the preceding 3 months; or any other condition deemed inappropriate by the investigator.