الفهرس 
Introductionيوجد فقط 14 صفحة متاحة للعرض العام
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المستخلص
The main objective of this work was to study the role preoperative
assessment of portal hypertension surrogate markers to predict early
postoperative morbidity and mortality in patients underwent hepatic
resection of HCC.
records from hepatocellular carcinoma registry at National Liver
Institute, Menoufiya University from 2010 to 2012. The records
included 71 patients diagnosed as having hepatocellular carcinoma and
underwent hepatic resection.
Data collected included demographic data, preoperative data, operative
criteria, and postoperative data (early morbidity and mortality) then data
statistically analyzed for significance and, It was found that:
The mean age of the HCC patients was 55.1. There was no
significant correlation between age and postoperative complication.
HCC has a strong male predominance with a male to female ratio
9.1/1. There was no significant correlation between gender and
postoperative complications.
The underlying etiology of most HCC patients was HCV related
cirrhosis (94.4%) while HBV related cirrhosis constituted (1.4%).
Child-Pugh A patients with portal hypertension have short- term
results similar to patients with normal portal pressure.
According to MELD score, the majority of patients (88.7%) were
between 6 and 9.
Patients with portal hypertension had worse preoperative
laboratory investigations than patients without portal hypertension.
Open hepatic resection was the preferred approach in the majority
of patients (94.4%) and Habib needle was the preferred tool of
resection in (83%) of patients.
There was no statistical difference in occurrence of postoperative
general complications between PHTN group and patients without
portal hypertension.
There was increased incidence of hepatic encephalopathy
postoperatively among patients with PHTN than patients without
portal hypertension.
Post-operative prolongation of INR demonstrated among patients
with PHTN postoperatively.
There was no significant difference between patients with PHTN
and patients without PHTN regarding mortality and tumor
recurrence in 1 year follow up postoperatively,
Dilated portal vein diameter should not be taken as a certain
measurement of PHT as degree of post-operative complication
showed no difference with others with normal portal vein diameter.
Platelet count less than 100,000/mm3 is independently associated
with increased rate of intraoperative bleeding and blood and its
products transfusion.
Platelet count less than 100,000/mm3 is independently associated
with increased occurrence of hepatic encephalopathy.
Presence of esophageal varices preoperatively in patients
undergoing hepatic resection has a risk of occurrence of bleeding
and bile leakage postoperatively.
Our results suggest that Portal hypertension should not be
considered an absolute contraindication to hepatectomy in cirrhotic
patients.