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01-07-2021 | Liver Resection

Safety and feasibility of laparoscopic liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a propensity score-matched study

Authors: Junhao Zheng, Xu Feng, Yuelong Liang, Jingwei Cai, Zhaoqi Shi, Mubarak Ali Kirih, Liye Tao, Xiao Liang

Published in: Surgical Endoscopy | Issue 7/2021

Abstract

Background

The presence of clinically significant portal hypertension (CSPH) remains a relative contraindication to liver resection for patients with resectable hepatocellular carcinoma (HCC). The goal of this study was to explore whether a laparoscopic approach could extend the indications for hepatectomy to patients with PH.

Method

Patients who underwent laparoscopic liver resection (LLR) from February 2016 to September 2019 performed by a single medical team were included in this study. We analyzed the surgical and oncological outcomes between groups with and without CSPH before and after propensity score matching (PSM).

Result

We enrolled 156 patients divided into two groups according to the presence (CSPH, n = 26) or absence (non-CSPH, n = 130) of CSPH. CSPH group was associated with more clinical signs of liver dysfunction (p < 0.05). After PSM (n = 48 patients), the CSPH group tended to have a longer postoperative hospital stay (p = 0.054); however, there was no difference in operation time (p = 0.329), blood loss volume (p = 0.392), transfusion rates (p = 0.701), rate of conversion to open surgery (p = 0.666), surgical margin (p = 0.306), surgical mortality (n = 0), or comprehensive complication index (p = 0.844) between the two groups. The median follow-up time for the entire cohort was 19.6 months (range 0.2–40.6 months). The 3-year overall survival rate was 62.9% in the CSPH group and 84.3% in the non-CSPH group (p = 0.1090), and results were similar after PSM (p = 0.5734).

Conclusions

LLR is safe and feasible for HCC with PH. The introduction of minimally invasive surgery, represented by LLR, can appropriately expand the indications for hepatectomy.

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Title: Safety and feasibility of laparoscopic liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a propensity score-matched study
Authors: Junhao Zheng
Xu Feng
Yuelong Liang
Jingwei Cai
Zhaoqi Shi
Mubarak Ali Kirih
Liye Tao
Xiao Liang
Publication date: 01-07-2021
Publisher: Springer US
Keywords: Liver Resection
Liver Resection
Hepatocellular Carcinoma
Hepatocellular Carcinoma
Hypertension
Portal Hypertension
Portal Hypertension
Published in: Surgical Endoscopy / Issue 7/2021
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-020-07763-6

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Safety and feasibility of laparoscopic liver resection for hepatocellular carcinoma with clinically significant portal hypertension: a propensity score-matched study

Abstract

Background

Method

Result

Conclusions

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Method

Result

Conclusions

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