Invasive measurement of hepatic venous pressure gradient before resection of hepatocellular carcinoma.
HVPG
cirrhosis
hepatocellular carcinoma
liver resection
portal hypertension
Journal
Clinical and experimental hepatology
ISSN: 2392-1099
Titre abrégé: Clin Exp Hepatol
Pays: Poland
ID NLM: 101703431
Informations de publication
Date de publication:
Sep 2023
Sep 2023
Historique:
received:
10
04
2023
accepted:
11
07
2023
medline:
4
10
2023
pubmed:
4
10
2023
entrez:
4
10
2023
Statut:
ppublish
Résumé
To evaluate the role of hepatic venous pressure gradient (HVPG) measurement in patients with resectable hepatocellular carcinoma (HCC) we describe our experience with the procedure as part of our hospital standard preoperative algorithm. We present our protocol for this situation, the HVPG measurement procedure, and the results of our cohort. We performed a retrospective statistical analysis of all patients who underwent planned hepatic resection for HCC with HVPG measurement between 1/2016 and 1/2023. The cohort included 35 patients (30 males, mean age 69.5 years) who underwent HVPG measurement before liver resection for HCC. The success rate of measurement was 91.4%, with serious complications in 2.9% of cases. Due to the clinically significant portal hypertension (CSPH) 31.3% of patients were rejected for resection. Seventeen patients with excluded CSPH underwent resection with one case of a postoperative liver event, liver decompensation, representing 5.9% of them. One patient (5.9%) had a complicated postoperative course with fasciitis. None of the patients who underwent resection (88.2%) was readmitted to the hospital due to surgical complications or a liver event during 90 days of follow-up, and no death was reported. The median overall survival (OS) in the resected subgroup was 70 months (95% CI: 52-86), and in patients rejected for surgery (resection and transplantation) 35 months (95% CI: 13-48). HVPG measurement is the gold standard for the quantification of portal hypertension. Hepatic vein catheterization is invasive, but a safe procedure, with a clear impact on the management of resectable HCC.
Identifiants
pubmed: 37790686
doi: 10.5114/ceh.2023.130662
pii: 51287
pmc: PMC10544066
doi:
Types de publication
Journal Article
Langues
eng
Pagination
236-242Informations de copyright
Copyright © 2023 Clinical and Experimental Hepatology.
Déclaration de conflit d'intérêts
The authors declare no conflict of interest.
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