Portal hemodynamics before and after liver resection and its correlation with post-hepatectomy liver failure in patients with Child-Pugh class A: analysis of 151 consecutive cases.

BACKGROUND/AIMS: Low portal velocity (PV) was found in cirrhotic patients, which was thought to be a risk factor for post-hepatectomy liver failure (PHLF). This study attempted to find out whether a correlation existed between portal hemodynamics and PHLF.

METHODOLOGY

From December 2010 to December 2012, all consecutive patients with Child-Pugh class A underwent liver resection were included. PV and PF were measured by using Doppler ultrasound preoperatively and on postoperative day 3. Portal hemodynamics change was explored. Univariable and multivariable analysis were used to identify risk factors for PHLF.

RESULTS

PHLF occurred in 25 of 151 patients, and persistent PHLF in 9 patients. Mean portal velocity change (PVmeanC) was significantly different between patients with PHLF and patients without PHLF, but it failed to be identified as independent predictor for PHLF in multivariate analysis, which found alanine aminotransferase (ALT) and Ishak score significantly associated with PHLF, and only ALT significantly associated with persistent PHLF. Subgroup analysis of the 73 cirrhotic patients also showed that none of the portal hemodynamic parameters were independent risk factors for PHLF or persistent PHLF.

CONCLUSIONS

None of the portal hemodynamic parameters could be used to predict PHLF or persistent PHLF.