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Hepatic resection for hepatocellular carcinoma in cirrhotic patients with portal hypertension
Author(s) -
Zakaria Hazem M.,
Gad Emad H.,
Nada Ali,
Abdelaleem Anwar A.,
Maher Doha,
Abdel Samea Mohammad E.,
Sabry Alyaa
Publication year - 2016
Publication title -
surgical practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.109
H-Index - 10
eISSN - 1744-1633
pISSN - 1744-1625
DOI - 10.1111/1744-1633.12215
Subject(s) - medicine , hepatocellular carcinoma , gastroenterology , perioperative , cirrhosis , portal hypertension , resection , surgery
Aim Hepatic resection ( HR ) in cirrhotic patients with hepatocellular carcinoma ( HCC ) and portal hypertension ( PHT ) is not recommended, according to international guidelines. The aim of the present study was to determine the outcome of HR for HCC in cirrhotic patients with PHT . Methods The present study was a single institutional, retrospective study of 170 Child–Pugh class A cirrhotic patients who underwent HR for HCC from 2011 to July 2015. The patients were divided into two groups, according to the presence and absence of PHT . Results PHT was present in 91 patients (53.5 per cent). The postoperative morbidity was insignificantly higher in patients with PHT than patients without PHT (31.9 per cent vs 25.3 per cent, respectively, P = 0.36). Patients with PHT showed 90‐day perioperative mortality (3.3 per cent), which was similar to patients without PHT (2.5 per cent). In the subgroup analysis, t he 1‐, 3‐ and 5‐year overall survival for patients with limited HR was 90.3 per cent, 74.3 per cent and 66.2 per cent, respectively, for patients with PHT , and 93.9 per cent, 80.9 per cent and 73.6 per cent, respectively, for patients without PHT , without a significant statistical difference ( P = 0.38). Conclusion HR in Child–Pugh class A cirrhotic patients with PHT is a safe and effective procedure with good short‐ and long‐term outcomes in comparison to patients without PHT, especially those with limited liver resection.