Measurement of portal venous pressure is useful for selecting the optimal type of resection in cirrhotic patients with hepatocellular carcinoma.

BACKGROUND/AIMS: 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.

METHODOLOGY

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.