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Langenbeck's Archives of Surgery
Published in: Langenbeck's Archives of Surgery 1/2021

01-02-2021 | Liver Resection | Original Article

Post-hepatectomy liver failure after hepatic resection for hepatocellular carcinoma: a single center experience

Authors: Ahmed Shehta, Ahmed Farouk, Amgad Fouad, Ahmed Aboelenin, Ahmed Nabieh Elghawalby, Rami Said, Mohamed Elshobary, Ayman El Nakeeb

Published in: Langenbeck's Archives of Surgery | Issue 1/2021

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Abstract

Purpose

Post-hepatectomy liver failure (PHLF) is one of the most feared morbidities after liver resection (LR) for hepatocellular carcinoma (HCC). We aimed to investigate the incidence and predictors of PHLF after LR for HCC and its impact on survival outcomes.

Methods

We reviewed the patients who underwent LR for HCC during the period between January 2010 and 2019.

Results

Two hundred sixty-eight patients were included. Patients were divided into two groups according to the occurrence of PHLF, defined according to ISGLS. The non-PHLF group included 138 patients (51.5%), while the PHLF group included 130 patients (48.5%). Two hundred forty-six patients (91.8%) had hepatitis C virus. Major liver resections were more performed in the PHLF group (40 patients (30.8%) vs. 18 patients (13%), p = 0.001). Longer operation time (3 vs. 2.5 h, p = 0.001), more blood loss (1000 vs. 500 cc, p = 0.001), and transfusions (81 patients (62.3%) vs. 52 patients (37.7%), p = 0.001) occurred in PHLF group. The 1-, 3-, and 5-year Kaplan-Meier overall survival rates for the non-PHLF group were 93.9%, 79.5%, and 53.9% and 73.2%, 58.7%, and 52.4% for the PHLF group, respectively (log rank, p = 0.003). The 1-, 3-, and 5-year Kaplan-Meier disease-free survival rates for the non-PHLF group were 77.7%, 42.5%, and 29.4%, and 73.3%, 42.9%, and 25.3% for the PHLF group, respectively (log rank, p = 0.925). Preoperative albumin, bilirubin, INR, and liver cirrhosis were significant predictors of PHLF in the logistic regression analysis.

Conclusion

Egyptian patients with HCC experienced higher PHLF incidence after LR for HCC. PHLF significantly affected the long-term survival of those patients.
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Metadata
Title
Post-hepatectomy liver failure after hepatic resection for hepatocellular carcinoma: a single center experience
Authors
Ahmed Shehta
Ahmed Farouk
Amgad Fouad
Ahmed Aboelenin
Ahmed Nabieh Elghawalby
Rami Said
Mohamed Elshobary
Ayman El Nakeeb
Publication date
01-02-2021
Publisher
Springer Berlin Heidelberg
Published in
Langenbeck's Archives of Surgery / Issue 1/2021
Print ISSN: 1435-2443
Electronic ISSN: 1435-2451
DOI
https://doi.org/10.1007/s00423-020-01956-2

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