Sie befinden Sich nicht im Netzwerk der Universität Paderborn. Der Zugriff auf elektronische Ressourcen ist gegebenenfalls nur via VPN oder Shibboleth (DFN-AAI) möglich. mehr Informationen...
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
Quelle
Wiley Online Library All 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.