Portal pressure following partial to extensive hepatic resection in patients with and without cirrhosis of the liver.

In 24 patients with and without cirrhosis of the liver, portal vein pressure was measured prior to and after hepatic resections of various magnitudes. In 6 patients who underwent resection of less than 20% of the liver portal pressure did not change although all patients had associated cirrhosis. On the other hand, a substantial rise in portal pressure was found in 17 of 18 patients who had resection of more than 30% of the liver irrespective of the presence or absence of cirrhosis. No significant difference was observed between the degree of portal pressure rise and the magnitude of hepatic resection. Also, there was no difference in the increase in portal pressure between the patients with and without cirrhosis of the liver. The present study may indicate that splanchnic sequestration associated with acute portal hypertension frequently occurs even in humans after resection of 30% or more of the liver even if the remaining liver is normal and anatomical dissection has been employed. Appropriate intra- and postoperative management is necessary to combat this difficult condition.