Details

Autor(en) / Beteiligte

• Casellas-Robert, Margarida
• Lim, Chetana
• Lopez-Ben, Santiago
• Lladó, Laura
• Salloum, Chady
• Codina-Font, Jaume
• Comas-Cufí, Marc
• Ramos, Emilio
• Figueras, Joan
• Azoulay, Daniel

Titel

Laparoscopic Liver Resection for Hepatocellular Carcinoma in Child–Pugh A Patients With and Without Portal Hypertension: A Multicentre Study

Ist Teil von

• World journal of surgery, 2020-11, Vol.44 (11), p.3915-3922

Ort / Verlag

Cham: Springer International Publishing

Erscheinungsjahr

2020

Link zum Volltext

Quelle

Wiley Online Library - AutoHoldings Journals

Beschreibungen/Notizen

• Background Laparoscopic liver resection (LLR) may improve outcomes for cirrhotic patients with hepatocellular carcinoma (HCC) and portal hypertension (PHT). The aim of this study was to compare the short-term outcomes after LLR for HCC in cirrhotic patients with and without PHT. Methods This multicentric study included 96 HCC patients who underwent LLR. Clinically significant portal hypertension (CSPH) was defined by a hepatic venous pressure gradient ≥10 mmHg. Short-term outcomes and liver-specific complications including post-hepatectomy liver failure (PHLF), ascites and encephalopathy were compared between patients with and without CSPH. Results Thirty-one patients (32%) had CSPH. The CSPH group had higher post-operative morbidity (52% vs. 15%; p  < 0.001), PHLF (10% vs. 0%; p  = 0.03) and encephalopathy (10% vs. 0%; p  = 0.03). There was no difference in terms of post-operative ascites between the two groups (CSPH: 16% vs. no CPSH: 8%, p  = 0.28). The length of stay was longer in patients with CSPH than in those without CSPH (6 vs. 4 days; p  < 0.001). Conclusions The laparoscopic approach is feasible in selected HCC patients with CSPH, at the price of significant increases in liver-specific complications and length of stay.