Natural Ending or Surgical Complication: Is It the Time to Reconsider the Clavien-Dindo Classification System?

To date, the Clavien-Dindo classification system represents the most popular assessment tool of postoperative events that ranks surgical complications by the extent of respective required therapeutic interventions. This uniform grading system allows for an objective evaluation of outcomes from a surgical procedure by accurately and standardly defining surgical complications. However, many scientists have meanwhile heavily criticized the Clavien-Dindo classification system as an overly generalized and conservative grading system that requires modification. Herein, we aim to explain the need for reconsideration of the Clavien-Dindo classification system, and discuss the features of an ideal system for the classification of complications that should evaluate not only surgical complications, but also the risk and patient's general performance status.