Severity of portal hypertension and prediction of postoperative liver failure after liver resection in patients with Child–Pugh grade A cirrhosis

Abstract

The severity of CSPH, corresponding to different PVP levels, could be used to stratify patients with Child-Pugh grade A cirrhosis and to predict the incidence of PHLF. Patients with severe CSPH or a NLR of 2·8 or above were more likely to develop persistent PHLF after partial hepatectomy.

Liver failure after hepatocellular carcinoma surgery

“…It is not surprising that preoperative increased bilirubin and INR levels were identified as significant predictors of PHLF in the present study, because these two parameters are well-known indices of liver function [14], as well as predictors of mortality from hepatic decompensation after liver resection [18,19]. In line with this, several previous studies have revealed that impaired preoperative liver function and underlying liver disease are significant predictors of impaired postoperative liver function [7,9,12,[33][34][35][36][37]. Sitzmann and his colleague reported that the serum bilirubin value at admission is a significant preoperative predictor of morbidity after hepatectomy [38].…”

A Comparative Study of Albumin-Bilirubin Score with Child-Pugh Score, Model for End-Stage Liver Disease Score and Indocyanine Green R15 in Predicting Posthepatectomy Liver Failure for Hepatocellular Carcinoma Patients

“…The MELD score was calculated using the formula: 11.2 × ln (international normalized ratio) + 9.57 × ln (creatinine, mg/dL) + 3.78 × ln (bilirubin, mg/dL) + 6.43 [19]. Clinically significant portal pressure (CSPH) was defined as the presence of esophageal varices or in those with a low platelet count (<100 ×10 9 /L) with splenomegaly [20]. Gastrointestinal endoscopy was undertaken to detect esophageal varices.…”

Influence of Clinically Significant Portal Hypertension on Hepatectomy for Hepatocellular Carcinoma: a Meta-analysis

“…Increasing portal vein pressure, obtained by direct measurement during surgery, was found associated with both high rate of post-operative liver failure and poor long-term survival (Chen et al, 2012;Hidaka et al, 2012). Liver stiffness measurement (LSM) using transient elastography is a new non-invasive method, and shows a linear correlation with portal pressure (Ziol et al, 2005;Vizzutti et al, 2007).…”