A Predictive Formula for Portal Venous Pressure Prior to Liver Resection Using Directly Measured Values

Masaaki Hidaka, Susumu Eguchi, Takanobu Hara, Akihiko Soyama, Satomi Okada, Takashi Hamada, Shinichiro Ono, Tomohiko Adachi, Kengo Kanetaka, Mitsuhisa Takatsuki
2018 Journal of investigative surgery  
Purpose: Despite refinements in surgical techniques for liver resection, evaluation of hepatic reserve disparity remains one of the most common problems in liver surgery, especially for hepatic malignancies such as hepatocellular carcinoma (HCC). Portal venous pressure (PVP) is regarded one of the important factors in selecting treatment strategy, although its measurement can be invasive and complex. Methods: To establish a formula for calculating PVP preoperatively, intraoperative directly
more » ... ured PVP was used in 177 patients with preoperative factors and liver function tests such as age, sex, virus status, platelet count, prothrombin time, albumin, total bilirubin, alanine aminotransferase (ALT), Child-Pugh grade, liver damage defined by the Liver Cancer Study Group of Japan, indocyanine green retention rate at 15 min (ICG-R15), and the aspartate transaminase (AST)-platelet ratio index (APRI). Results: After multiple regression analysis, the formula PVP (cmH2O) = EXP[2.606+ 0.01×(ICG-R15)+0.015×APRI] was established from the measured data (r = .495 (p<0.01)). Conclusion: Considering its simplicity of use, we have adopted the formula for predicting PVP in determining treatment strategy for HCC and other hepatic malignancies. LQ et al. Albumin-bilirubin versus Child-Pugh score as a predictor of outcome after liver resection for hepatocellular carcinoma. Br J Surg. 2016, 103:725-734. 11) Kokudo T, Hasegawa K, Amikura K, Uldry E, Shirata C, Yamaguchi T, Arita J, Kaneko J, Akamatsu N, Sakamoto Y et al. Assessment of preoperative liver function in patients with hepatocellular carcinoma -the albumin-indocyanine green evaluation (ALICE) grade. PLoS One. 2016, 11:e0159530. 12) Ikai I, Arii S, Kojiro M, Ichida T, Makuuchi M, Matsuyama Y, Nakanuma Y, Okita K, Omata M, Takayasu K et al. Reevaluation of prognostic factors for survival after liver resection in patients with hepatocellular carcinoma in a Japanese Nationwide Survey. Cancer 2004, 101:796-802. 13) Eguchi S, Kanematsu T, Arii S, Okazaki M, Okita K, Omata M, Ikai I, Kudo M, Kojiro M, Makuuchi M et al. Comparison of the outcomes between an anatomical subsegmentectomy and a non-anatomicalminor hepatectomy for single hepatocellular carcinomas based on a Japanese nationwide survey. Surgery. 2008, 143:469-475.
doi:10.1080/08941939.2018.1476631 pmid:29856668 fatcat:d5gb3xfrkrdm7c3ie3bbbj3zpa