caa a22 4500 606248935 CHVBK 20210128101353.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s12262-014-1065-y doi (NATIONALLICENCE)springer-10.1007/s12262-014-1065-y Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy [Elektronische Daten] [Atsushi Nanashima, Takafumi Abo, Junichi Arai, Tomoshi Tsuchiya, Takuro Miyazaki, Katsunori Takagi, Xiaohui Chen, Takeshi Nagayasu] Portal hypertension is a major risk factor for hepatic failure or intestinal bleeding in patients with liver disease but cannot be measured indirectly. We attempted to comprehensively evaluate preoperative parameters of functional liver reserve that correlated with portal pressure (PP) in patients with various liver diseases. We examined 93 patients in whom portal pressure was directly measured during preoperative portal vein embolization (PVE) or operation. Background liver included chronic viral liver disease in 43 patients, obstructive jaundice in 29 patients, and normal liver in 21. Multivariate logistic analysis and linear regression analysis were applied to create a predictive formula for PP. Mean PP was 13.4 ± 4.9cm H2O, and PP was significantly associated with severity of liver injury, hepatic fibrosis, intraoperative blood loss, and post-hepatectomy morbidity (p < 0.05 each). Mean PP after PVE (22.5 ± 7.8cm H2O) was significantly increased compared to that before embolization (13.1 ± 4.7cm H2O; p < 0.01). Univariate analysis identified seven significant parameters of preoperative liver function associated with PP: indocyanine green (ICG) test result, liver uptake and clearance index (HH15) on 99mTc-galactosyl serum albumin liver scintigraphy, total bilirubin level, prothrombin activity, and hyaluronate level. Using multiple linear regression analysis, the predictive formula using ICG and HH15 was as follows: Y (estimated PP) = 0.273 + 0.086 × ICGR15 + 0.193 × HH15. The calculated PP (11.5 ± 4.6cm H2O (−1.9cm H2O)) was lower than true PP, which was significantly associated with post-hepatectomy morbidity (p < 0.05). The correlation between true and calculated PP was weak, and prediction using the conventional liver functional parameters was limited at present and, however, estimating PP appears to be useful in evaluating portal hypertension and post-hepatectomy morbidity. Association of Surgeons of India, 2014 Hepatectomy nationallicence Liver functional reserve nationallicence Portal pressure nationallicence 99mTc-GSA liver scintigraphy nationallicence Portal vein embolization nationallicence Nanashima Atsushi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Abo Takafumi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Arai Junichi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Tsuchiya Tomoshi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Miyazaki Takuro Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Takagi Katsunori Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Chen Xiaohui Division of Oncological Surgery, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China aut Nagayasu Takeshi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut Indian Journal of Surgery Springer India 77(2015-12-01), 923-929 0972-2068 77<923 2015 77 12262 https://doi.org/10.1007/s12262-014-1065-y text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s12262-014-1065-y text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Nanashima Atsushi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Abo Takafumi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Arai Junichi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Tsuchiya Tomoshi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Miyazaki Takuro Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Takagi Katsunori Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 700 1- Chen Xiaohui Division of Oncological Surgery, Teaching Hospital of Fujian Medical University, Fuzhou, Fujian, People's Republic of China aut NATIONALLICENCE 700 1- Nagayasu Takeshi Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, 8528501, Nagasaki, Japan aut NATIONALLICENCE 773 0- Indian Journal of Surgery Springer India 77(2015-12-01), 923-929 0972-2068 77<923 2015 77 12262