Dynamic changes of portal vein pressure gradient under different degrees of liver cirrhosis and resection volume in the first week post hepatectomy.

Abstract

We set out to acquire original pathophysiologic data of dynamic changes in portal vein pressure gradient (PVPG) following liver resection (LR) during post-operation days (POD) 1-7. Portal vein pressure gradient was measured in 31 patients daily until POD 7 at our liver surgery center. Patients were divided into non-, mild, moderate, and severe cirrhosis groups according to histopathology and were also divided into subgroups according to the volume of hepatectomy. Portal vein pressure gradient reached its peak on POD 3 in mild cirrhosis (F = 7.525, P < 0.001), moderate cirrhosis (F = 11.200, P < 0.001), and severe cirrhosis groups (F = 26.634, P < 0.001). There were no significant changes in PVPG in the non-cirrhosis group (F = 1.050, P = 0.411). Moreover, PVPG on POD 3 was higher with increasing severity of cirrhosis under the same interval of LR volume (resection volume <200cm3 : F = 13.040, P = 0.004; ≥200cm3 but <400cm3 : F = 13.243, P = 0.004; ≥400cm3 : F = 43.685, P < 0.001). Finally, the LR volume had significant impact on PVPG for patients with moderate cirrhosis (F = 6.339, P = 0.033) and severe cirrhosis (t = -7.000, P = 0.020). A similar tendency was also observed when patients were divided according to the ratio of the resected liver volume to total liver volume. The increase in PVPG following LR was positively associated with the degree of cirrhosis, significantly peaking on POD 3. The LR volume only had a significant impact on PVPG for patients with moderate and severe cirrhosis. This represents the first time, to our knowledge, that dynamic changes of PVPG after LR were measured and compared to cirrhosis and resection volume.