Duan YF, Li XD, Sun DL, Chen XM, An Y, Zhu F. A preliminary study on surgery for hepatocellular carcinoma patients with portal hypertension.
Am J Surg 2014;
210:129-33. [PMID:
25457251 DOI:
10.1016/j.amjsurg.2014.08.022]
[Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2014] [Revised: 07/22/2014] [Accepted: 08/04/2014] [Indexed: 02/07/2023]
Abstract
BACKGROUND
To assess the effects of various operations for hepatocellular carcinoma with portal hypertension (PH).
METHODS
Data regarding 78 patients with resectable liver cancer with PH were analyzed. Patients were divided into 3 groups: A (splenic artery ligation), B (in situ splenectomy), and C (in situ splenectomy + pericardial devascularization).
RESULTS
White blood cell and platelet counts in the 3 groups increased significantly after surgery. Postoperative portal pressure was not significantly lower than preoperative portal pressure in Group A, while it was significantly lower in B. In Group C, the portal pressure after splenectomy was significantly lower than that before the operation, but not again after pericardial devascularization. The 1-, 2-, and 3-year survival rates of all the patients were 89.7%, 64.1%, and 46.1%, respectively.
CONCLUSIONS
PH is not an absolute contraindication to liver resection in Child-Pugh class B cirrhotic patients. The combined surgery for hepatocellular carcinoma patients with PH is a safe choice.
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