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World Journal of Surgery

, Volume 36, Issue 2, pp 392–400 | Cite as

Adverse Outcomes in Patients with Postoperative Ascites after Liver Resection for Hepatocellular Carcinoma

  • Kun-Ming Chan
  • Chen-Fang Lee
  • Ting-Jung Wu
  • Hong-Shiue Chou
  • Ming-Chin Yu
  • Wei-Chen Lee
  • Miin-Fu Chen
Article

Abstract

Background

Postoperative ascites (POA) is a common complication after liver resection (LR). The aim of the present study was to identify the risk factors for developing POA and to evaluate its clinical significance in the prognosis of patients with hepatocellular carcinoma (HCC).

Methods

We performed a retrospective analysis of data obtained from 651 patients who underwent LR for the treatment of HCC between January 2001 and July 2005. The patients selected for the study were categorized and analyzed on the basis of the presence or absence of POA.

Results

Overall, 166 (25.5%) patients developed POA. A multivariate logistic regression analysis identified that five significant factors—cirrhotic liver, high indocyanine green retention, portal hypertension, hypoalbuminemia, and extent of LR—were associated with the development of POA. The recurrence-free survival and overall survival of patients with POA were significantly lower than those of patients without POA. The 5-year recurrence-free survival rates of patients with intractable POA over those of patients without POA were 31.7% versus 36.1%, and the corresponding 5-year overall survival rates were 17.4% versus 57.0%. The relative risk of mortality within 1 year in patients with POA was 2.4 times (95% confidence interval, 1.76–3.27; p < 0.001) higher than that in patients without POA.

Conclusions

A nomogram for predicting the probability of POA after LR for HCC was constructed on the basis of the identified risk factors, which may be used for risk-stratifying patients who may or may not benefit from surgical resection. Because patients with POA after LR show a high incidence of HCC recurrence and mortality risk, those with intractable ascites should be considered for prompt liver transplantation.

Keywords

Overall Survival Liver Resection Portal Hypertension Overall Survival Rate Cirrhotic Liver 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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Copyright information

© Société Internationale de Chirurgie 2011

Authors and Affiliations

  • Kun-Ming Chan
    • 1
  • Chen-Fang Lee
    • 1
  • Ting-Jung Wu
    • 1
  • Hong-Shiue Chou
    • 1
  • Ming-Chin Yu
    • 1
  • Wei-Chen Lee
    • 1
  • Miin-Fu Chen
    • 1
  1. 1.Division of Liver and Organs Transplantation Surgery, Department of General SurgeryChang Gung Memorial Hospital at Linkou, Chang Gung University College of MedicineTaoyuanTaiwan

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