Influence of portal hypertension on postoperative complications after hepatectomy for hepatocellular carcinoma

Abstract

Objective To investigate the influence of portal hypertension (PHT) on the postoperative complications after hepatectomy for patients with hepatocellular carcinoma (HCC). Methods Clinical data of 152 HCC patients undergoing hepatectomy in Sun Yat-sen University Cancer Center from March 2003 to October 2005 were retrospectively analyzed. The patients were divided into the PHT and non-PHT groups. There were 76 patients in the PHT group including 62 males and 14 females, with a mean age of (49±11) years. There were 76 patients in the non-PHT group including 66 males and 10 females, with a mean age of (49±12) years. The informed consents of all patients were obtained and the local ethical committee approval had been received. After hospitalization, all patients received routine examination. The incidence of postoperative complications in two groups was observed and the independent risk factors for postoperative complications were evaluated. Normally distributed data were compared using t test. Non-normally distributed data were compared using Z test. The comparison of rate was conducted using Chi-square test. Independent risk factors for the incidence of postoperative complications were analyzed by Logistic multivariate regression test. Results The incidence of postoperative complications was 42% (32/76) and the liver function-related complications was 36% (27/76) in the PHT group, and were 20% (15/76), 16% (12/76) respectively in the non-PHT group, significant difference was observed between two groups (χ2=8.901, 7.760; P 0.05). No significant difference was observed in the 90-day mortality between PHT group [7% (5/76)] and non-PHT group [3% (2/76)] (χ2=0.599, P>0.05). Logistic regression analysis revealed that PHT complication (OR=3.376, 95%CI: 1.564-7.287, P 2 (OR=1.984, 95%CI: 1.248-3.154, P 2 (OR=1.832, 95%CI: 1.137-2.952, P 400 ml (OR=2.776, 95%CI: 1.123-6.864, P<0.05) were the independent risk factors for liver function-related complications. Conclusions PHT can increase the incidences of postoperative complications and liver function-related complications after hepatectomy in HCC patients and is the independent risk factor for both complications. However, PHT will not increase the severity of postoperative complications or postoperative mortality. Key words: Carcinoma, hepatocellular; Hypertension, portal; Postoperative complications