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Lookup NU author(s): John Hammond
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© 2020 International Hepato-Pancreato-Biliary Association Inc.Background: There are evolving data correlating elevated post-hepatic resection portal vein pressure (PVP) with risk of developing post-resection liver failure (PLF) and other complications. As a consequence, modulation of PVP presents a potential strategy to improve outcomes following liver resection (LR). The primary aim of this study was to review the existing evidence regarding the impact of post-resection PVP on clinical outcomes in patients undergoing a LR. Methods: Systematic literature searches of electronic databases in accordance with PRISMA were conducted. Changes in PVP and clinical outcomes following liver resection were defined according to the existing literature. Results: Ten studies, consisting of 712 patients with a median age 61 (52–68) years, were identified that met the inclusion criteria. Of those, 77% (n = 550) underwent a major LR and 27% (n = 195) of patients had cirrhosis. Following LR, the median (range) PVP increased from 11.4 mmHg (median baseline, range 7.3–16.4) to 15.9 mmHg (7.9–19). The overall median incidence of PLF was 19%. Six of the ten studies found an elevated PVP after LR predicted PLF. One study found elevated PVP after LR predicted mortality after LR. Conclusion: Elevated PVP following hepatic resection was associated with increased rates of PLF. It was not possible to define a specific threshold PVP for predicting PLF. Modulation of PVP therefore presents a potential strategy to mitigate the incidence of LR. Future studies should standardize on reporting liver remnant and haemodynamics to better characterize clinical outcomes following LR.
Author(s): Gavriilidis P, Hammond JS, Hidalgo E
Publication type: Review
Publication status: Published
Journal: HPB
Year: 2020
Volume: 22
Issue: 11
Pages: 1521-1529
Print publication date: 01/11/2020
Online publication date: 10/08/2020
Acceptance date: 09/07/2020
ISSN (print): 1365-182X
ISSN (electronic): 1477-2574
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.hpb.2020.07.006
DOI: 10.1016/j.hpb.2020.07.006
PubMed id: 32792308
