Measurement of portal venous pressure is useful for selecting the optimal type of resection in cirrhotic patients with hepatocellular carcinoma.
OBJECTIVE
In the present study the importance of measurement of portal venous pressure was focused on to predict the postoperative liver function before liver surgery, particularly in cirrhotic patients.


METHODS
Ninety-two patients who underwent a hepatic resection for hepatocellular carcinoma (HCC) were retrospectively evaluated to predict their postoperative liver function by measuring the portal venous pressure.


RESULTS
The portal venous pressure was not significantly correlated with the preoperative value of the indocyanine green (ICG) retention test. In patients with an ICG of over 20%, the risk of occurrence of postoperative hyperbilirubinemia was high when a major hepatic resection was the procedure of choice. Even in patients with an ICG of below 20%, a few patients developed complications after surgery when major resection was carried out. For patients undergoing a small excision, the complications were nil when the ICG was below 20% and the pressure was below 200mm in saline.


CONCLUSIONS
The portal venous pressure was found to reflect to what degree the liver parenchyma is damaged. Measuring the portal venous pressure is useful for determining the final indications for surgery also in cirrhotic patients with HCC.
Kanematsu
Takashi
T
Department of Surgery II, Nagasaki University School of Medicine, Japan. kanematu@net.nagasaki-u.ac.jp
Furui
Junichiro
J
Yanaga
Katsuhiko
K
Okudaira
Sadayuki
S
Kamohara
Yukio
Y
Eguchi
Susumu
S
D000328:Adult; D000368:Aged; D001707:Biopsy, Needle; D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D015331:Cohort Studies; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D006932:Hyperbilirubinemia / Q000517:prevention & control*; D007150:Immunohistochemistry; D008103:Liver Cirrhosis / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D018579:Patient Selection; D017082:Portal Pressure; D011183:Postoperative Complications / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care / Q000379:methods; D012680:Sensitivity and Specificity; D016896:Treatment Outcome