Increase of Portal Vein Pressure Gradient After Hepatectomy Predicts Post-operative Liver Dysfunction
Background. Post-hepatectomy liver failure (PHLF) is an important cause of mortality and morbidity. Whether Child-Pugh A patients with varying degrees of cirrhosis are good candidates for hepatectomy is disputed. The purpose of this study was to analyze the impact of portal venous pressure gradient (PVPG) variation during surgery on PHLF. Methods. PVPG, the pressure gradient between the portal vein and central vein, was measured in consecutive patients before and after liver resection. The optimal cutoff of PVPG to predict PHLF was determined by receiver operating characteristic curve analysis. Risk factors for PHLF were subjected to univariate and multivariable analysis. Results. Sixty Child-Pugh A patients were recruited. The mean PVPG was increased from 5.17 ± 4.78 mm of mercury (mmHg) to 6.37 ± 4.44 mmHg after liver resection. The optimal cutoff value of PVPG increments to predict PHLF was 1.5 mmHg. Multivariable analysis showed prothrombin time (PT), post-hepatectomy PVPG increments of 1.5 mmHg or greater, and resected liver segments of 3 or more to be independent predictors of PHLF. Conclusions. Acute PVPG increase after hepatectomy is associated with a higher risk of PHLF in Child-Pugh A patients.
Medienart: |
E-Artikel |
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Erscheinungsjahr: |
2022 |
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Erschienen: |
2022 |
Enthalten in: |
Zur Gesamtaufnahme - volume:29 |
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Enthalten in: |
Surgical innovation - 29(2022), 2 vom: 05. Apr., Seite 145-153 |
Sprache: |
Englisch |
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Beteiligte Personen: |
Xiao, Nan [VerfasserIn] |
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Links: |
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Themen: |
Hepatectomy |
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Anmerkungen: |
Date Completed 19.04.2022 Date Revised 19.04.2022 published: Print-Electronic Citation Status MEDLINE |
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doi: |
10.1177/15533506211018620 |
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funding: |
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Förderinstitution / Projekttitel: |
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PPN (Katalog-ID): |
NLM325450803 |
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520 | |a Background. Post-hepatectomy liver failure (PHLF) is an important cause of mortality and morbidity. Whether Child-Pugh A patients with varying degrees of cirrhosis are good candidates for hepatectomy is disputed. The purpose of this study was to analyze the impact of portal venous pressure gradient (PVPG) variation during surgery on PHLF. Methods. PVPG, the pressure gradient between the portal vein and central vein, was measured in consecutive patients before and after liver resection. The optimal cutoff of PVPG to predict PHLF was determined by receiver operating characteristic curve analysis. Risk factors for PHLF were subjected to univariate and multivariable analysis. Results. Sixty Child-Pugh A patients were recruited. The mean PVPG was increased from 5.17 ± 4.78 mm of mercury (mmHg) to 6.37 ± 4.44 mmHg after liver resection. The optimal cutoff value of PVPG increments to predict PHLF was 1.5 mmHg. Multivariable analysis showed prothrombin time (PT), post-hepatectomy PVPG increments of 1.5 mmHg or greater, and resected liver segments of 3 or more to be independent predictors of PHLF. Conclusions. Acute PVPG increase after hepatectomy is associated with a higher risk of PHLF in Child-Pugh A patients | ||
650 | 4 | |a Journal Article | |
650 | 4 | |a hepatectomy | |
650 | 4 | |a liver failure | |
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700 | 1 | |a Huang, Cheng |e verfasserin |4 aut | |
700 | 1 | |a Shen, Ying-Hao |e verfasserin |4 aut | |
700 | 1 | |a Zhou, Jian |e verfasserin |4 aut | |
700 | 1 | |a Fan, Jia |e verfasserin |4 aut | |
700 | 1 | |a Sun, Hui-Chuan |e verfasserin |4 aut | |
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