Objective: To analyse the clinical curative effect and complications of primary hepatocellular carcinoma complicated with portal hypertension treated with hepatectomy.
Methods: The clinical data of 489 patients undergoing hepatectomy in our hospital were retrospectively analysed. Among them, 68 patients were complicated with portal hypertension (13.91%), and the remaining 421 patients were as control group without portal hypertension (86.09%). The postoperative complications, mortality, clinical baseline data, and survival rates were evaluated in two groups of patients, and the factors affecting survival were analysed with the Cox regression risk model.
Results: (1) Postoperative complications: observation group of 20.59% and control group of 13.54% (χ2=7.19, P<0.05). The mortality of the two groups was compared within the postoperative 30 d (χ2=2.91, P>0.05) and within 90 d after the operation (χ2=5.35, P<0.05) ; (2) The gender, age, tumor size, alphafetoprotein level, tumor histology, and margin of the two groups had no statistical difference (P>0.05), while the difference of total bilirubin level, number of foci, cased of Child-PughB grade and albumin level were statistically significant (P<0.05), using the Cox regression risk model, we found that only the number of cancer foci (OR=1.17, 95% CI: 0.90-1.732) and the diameter of tumor (OR=1.27, 95% CI: 0.984-1.844) were the independent risk factors (P<0.05) affecting the mortality after hepatectomy in HCC patients with cirrhosis. (3) The survival rates of the control group at 1st, 2nd, 5th and 6th year after operation were 91.1%, 79.2%, 56.21% and 41% respectively, while 84.9%, 69.3%, 48.2% and 22.3% of the observation group. The two groups were statistically significant (P<0.05).
Conclusion: Portal hypertension is not the absolute contraindication of radical resection of primary hepatocellular carcinoma. Small lesion hepatocellular carcinoma complicated with portal hypertension can choose the corresponding hepatectomy.Author(s): Hong Liu, Mingming Zhang, Jie Xing, Wujin Liang