Ann Hepatobiliary Pancreat Surg.  2016 Nov;20(4):153-158. 10.14701/ahbps.2016.20.4.153.

Risk factors of postoperative ascites on hepatic resection for hepatocellular carcinoma

• Choi SW
• Shin WY
• Lee KY
• Ahn SI

• KMID: 2362464
• DOI: http://doi.org/10.14701/ahbps.2016.20.4.153

Abstract

BACKGROUNDS/AIMS
The aim of this study was to identify the risk factors of the development of large amounts of ascites (LA) after hepatic resection for hepatocellular carcinoma (HCC).
METHODS
The medical records of 137 consecutive patients who underwent hepatic resection for HCC from January 2010 to December 2014 were retrospectively reviewed. Patients were divided into two groups: LA group, with ascites drainage >500 cc per day over 3 days (n=37) and control group (n=100). Preoperative and intraoperative clinical variables were compared between the two groups.
RESULTS
Thirty-seven (27.0%) patients developed LA. Platelet counts of <100,000/mm3, ICG-R15 >10%, CTP scores of 6 or 7 points, major resection, the presence of cirrhosis, preoperative ascites, and portal hypertension were significantly more frequent in LA group. Multivariate analysis revealed that a higher CTP score (HR=4.1), the presence of portal hypertension (HR=26.7), and major resection (HR=18.5) were independent and significant risk factors of postoperative ascites development. Persistent refractory ascites developed in 6 (16.2%) patients who succumbed to hepatic failure during follow-up.
CONCLUSIONS
Patients with a 6 or 7 point CTP score, major hepatic resection and/or portal hypertension were more likely to develop LA and experience deterioration of liver function after surgery. The selection of patients for hepatic resection should be based on a balanced assessment of the benefits of HCC treatment and risk of postoperative liver failure.

Keyword

Hepatocellular carcinoma; Ascites; Hepatectomy

MeSH Terms

Ascites*
Carcinoma, Hepatocellular*
Cytidine Triphosphate
Drainage
Fibrosis
Follow-Up Studies
Hepatectomy
Humans
Hypertension, Portal
Liver
Liver Failure
Medical Records
Multivariate Analysis
Platelet Count
Retrospective Studies
Risk Factors*
Cytidine Triphosphate

Figure

• 

  Fig. 1 Postoperative serum albumin concentrations in patients with (solid circles) and without (open circles) a large amount of ascites. Circles indicate mean values; whiskers, standard deviations.

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