胆红素正常的肝癌患者肝切除术后肝功能衰竭的术前危险因素

IF 1.3 4区医学 Q3 SURGERY

Cirugia Espanola Pub Date : 2024-12-01 DOI:10.1016/j.ciresp.2024.09.002

Xi He , Xiaofeng Zhang , Zhijie Li , Xiaofeng Niu, Lixin Li, Zhenwen Liu, Hui Ren, Dali Zhang

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引用次数: 0

摘要

背景和目的总胆汁酸（TBA）与门脉高压有关，门脉高压是肝切除术后肝衰竭（PHLF）的危险因素。我们进行这项研究是为了阐明TBA是否也与肝细胞癌（HCC）患者的PHLF相关。方法：我们招募肝细胞癌和Child-Pugh A级肝切除术患者，并应用多因素分析确定PHLF的危险因素。结果我们分析了154例患者的数据。PHLF患病率为14.3%。中位最大肿瘤直径为5.1 cm （2.9-6.9 cm）。在PHLF患者亚组中TBA水平升高（P = 0.001）、严重白蛋白-胆红素（AIBL）分级（P = 0.033）和血小板计数低（P = 0.031）的患者比例显著高于非PHLF患者亚组。多因素分析结果显示，TBA水平(OR, 1.08；951.03 - -1.14;P = 0.003)和MRI肿瘤直径(OR, 1.17；95% ci, 1.01-1.35；P = 0.038)是PHLF的独立术前危险因素。TBA水平与15分钟吲哚菁绿潴留率（P = 0.001）和有效肝血流量（P < 0.001）相关，这是门脉高压的两个标志。然而，TBA水平与肿瘤直径无关（P = 0.536）。结论与ICG R15和AIBL评分相比，术前TBA是中国HCC患者PHLF的危险因素，并可能通过其作为门脉高压的潜在标志影响PHLF。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Total bile acid as a preoperative risk factor for post-hepatectomy liver failure in patients with hepatocellular carcinoma and normal bilirubin

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Total bile acid as a preoperative risk factor for post-hepatectomy liver failure in patients with hepatocellular carcinoma and normal bilirubin

Background and aims

Total bile acid (TBA) is associated with portal hypertension, a risk factor for post-hepatectomy liver failure (PHLF). We conducted this study to clarify whether TBA is also associated with PHLF in patients with hepatocellular carcinoma (HCC).

Methods

We recruited patients with HCC and Child-Pugh class A, who underwent liver resection, and applied multivariate analyses to identify risk factors for PHLF.

Results

We analyzed data from 154 patients. The prevalence of PHLF was 14.3%. The median maximum tumor diameter was 5.1 cm (2.9–6.9 cm). The proportions of patients with elevated TBA levels (P = 0.001), severe albumin-bilirubin (AIBL) grades (P = 0.033), and low platelet counts (P = 0.031) were significantly higher within the subgroup of patients with PHLF than in the subgroup without PHLF. The multivariate analysis results suggest that TBA level (OR, 1.08; 951.03–1.14; P = 0.003) and MRI tumor diameter (OR, 1.17; 95% CI, 1.01–1.35; P = 0.038) are independent preoperative risk factors for PHLF. The TBA levels correlated with the indocyanine green retention rate at 15 minutes (P = 0.001) and the effective hepatic blood flow (P < 0.001), two markers of portal hypertension. However, TBA levels did not correlate with tumor diameter (P = 0.536).

Conclusions

Compared to ICG R15 and AIBL score, preoperative TBA was risk factor for PHLF in Chinese patients with HCC, and it may impact PHLF through its potential role as a marker of portal hypertension.

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来源期刊

Cirugia Espanola SURGERY-

CiteScore

1.20

自引率

21.10%

发文量

173

审稿时长

53 days

期刊介绍： Cirugía Española, an official body of the Asociación Española de Cirujanos (Spanish Association of Surgeons), will consider original articles, reviews, editorials, special articles, scientific letters, letters to the editor, and medical images for publication; all of these will be submitted to an anonymous external peer review process. There is also the possibility of accepting book reviews of recent publications related to General and Digestive Surgery.