Yun-Fei Duan1, Xiao-Dong Li2, Dong-Lin Sun1, Xue-Min Chen1, Yong An1, Feng Zhu3. 1. Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, Jiangsu Province, China. 2. Department of Oncology, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, Jiangsu Province, China. 3. Department of Hepatobiliary Surgery, The Third Affiliated Hospital of Soochow University, 185 Juqian Street, Changzhou, Jiangsu Province, China. Electronic address: dahe1971@163.com.
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.
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 carcinomapatients with PH is a safe choice.