ASO Author Reflections: Textbook Outcomes Following Liver Resection for Hepatic Neoplasms: A Realizable and Predictable Surgical Endpoint in the Real-World Scenario

PASTLiver resection remains a technically challenging surgery with potential for postoperative morbidity. 1Traditional outcome measures such as the Clavien-Dindo Classification (CDC) system and the Comprehensive Complication Index (CCI) are not tailored to the post-hepatectomy setting.This limitation was overcome when the International Study Group of Liver Surgery (ISGLS) proposed a classification of complications unique to hepatobiliary surgery. [2][3]][4] Despite this, there was an unmet need for a comprehensive and unified system to define the ideal postoperative course after liver resection and enable standardization and global comparison.Textbook Outcomes (TO) were developed to improve the quality of hospital care and prioritize patientcentered care.It was not until 2023 that an international expert consensus-based definition was proposed, using the formal Delphi approach. 5Regrettably, only 4.6% of the expert panel members represented lower-middle-income and low-income economies.