A preliminary study on surgery for hepatocellular carcinoma patients with portal hypertension

BACKGROUND: To assess the effects of various operations for hepatocellular carcinoma with portal hypertension (PH). METHODS: Data regarding 78 patients with resectable liver cancer with PH were analyzed. Patients were divided into 3 groups: A (splenic artery ligation), B (in situ splenectomy), and C (in situ splenectomy + pericardial devascularization). RESULTS: White blood cell and platelet counts in the 3 groups increased significantly after surgery. Postoperative portal pressure was not significantly lower than preoperative portal pressure in Group A, while it was significantly lower in B. In Group C, the portal pressure after splenectomy was significantly lower than that before the operation, but not again after pericardial devascularization. The 1-, 2-, and 3-year survival rates of all the patients were 89.7%, 64.1%, and 46.1%, respectively. CONCLUSIONS: PH is not an absolute contraindication to liver resection in Child-Pugh class B cirrhotic patients. The combined surgery for hepatocellular carcinoma patients with PH is a safe choice. (C) 2015 Elsevier Inc. All rights reserved.