Abstract
Background. Post-hepatectomy liver failure (PHLF) is an important cause of mortality and morbidity. Whether Child-Pugh A patients with varying degrees of cirrhosis are good candidates for hepatectomy is disputed. The purpose of this study was to analyze the impact of portal venous pressure gradient (PVPG) variation during surgery on PHLF. Methods. PVPG, the pressure gradient between the portal vein and central vein, was measured in consecutive patients before and after liver resection. The optimal cutoff of PVPG to predict PHLF was determined by receiver operating characteristic curve analysis. Risk factors for PHLF were subjected to univariate and multivariable analysis. Results. Sixty Child-Pugh A patients were recruited. The mean PVPG was increased from 5.17 ± 4.78mm of mercury (mmHg) to 6.37 ± 4.44mmHg after liver resection. The optimal cutoff value of PVPG increments to predict PHLF was 1.5mmHg. Multivariable analysis showed prothrombin time (PT), post-hepatectomy PVPG increments of 1.5mmHg or greater, and resected liver segments of 3 or more to be independent predictors of PHLF. Conclusions. Acute PVPG increase after hepatectomy is associated with a higher risk of PHLF in Child-Pugh A patients.
Highlights
Post-hepatectomy liver failure (PHLF) is an important cause of mortality and morbidity
Acute portal venous pressure gradient (PVPG) increase after hepatectomy is associated with a higher risk of PHLF in Child-Pugh A patients
Child–Pugh A patients have various degrees of cirrhosis, which are associated with different levels of risk for PHLF [4]
Summary
Post-hepatectomy liver failure (PHLF) is an important cause of mortality and morbidity. Whether Child– Pugh A Patients with varying degrees of cirrhosis are good candidates for hepatectomy is disputed. The purpose of this study was to analyse the impact of portal venous pressure gradient (PVPG) variation during surgery on PHLF
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