World Journal of Surgery

, Volume 38, Issue 9, pp 2370–2376 | Cite as

Preoperative Hepatitis B Virus DNA Level is a Risk Factor for Postoperative Liver Failure in Patients Who Underwent Partial Hepatectomy for Hepatitis B-Related Hepatocellular Carcinoma

  • Gang Huang
  • Wan Yee Lau
  • Feng Shen
  • Ze-ya Pan
  • Si-yuan Fu
  • Yun Yang
  • Wei-ping Zhou
  • Meng-chao Wu



Our objective was to explore the short-term effects of preoperative serum hepatitis B virus DNA level (HBV DNA) on postoperative hepatic function in patients who underwent partial hepatectomy for hepatitis B-related hepatocellular carcinoma (HCC).


The clinical data of 1,602 patients with hepatitis B-related HCC who underwent partial hepatectomy in our department were retrospectively studied. The patients were divided into three groups according to their preoperative HBV DNA levels: group A <200 IU/mL, group B 200–20,000 IU/mL, and group C >20,000 IU/mL. The rates of postoperative complications, especially the rate of postoperative liver failure, were compared.


There were significant differences among the three groups in the rates of postoperative liver failure. On multivariate logistic regression analysis, a high preoperative HBV DNA level was an independent risk factor for postoperative liver failure.


Preoperative HBV DNA level was a significant risk factor for postoperative hepatic dysfunction.


Partial Hepatectomy Entecavir Postoperative Liver Failure Postoperative Liver Dysfunction Preoperative Liver Function 
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.



The State Key Project on Infectious Diseases of China: 2008ZX10002-018, 2008ZX10002-025. The Creative Research Group, National Natural Science Foundation of China (30921006, 81081778).


  1. 1.
    El-Serag HB, Rudolph KL (2007) Hepatocellular carcinoma: epidemiology and molecular carcinogenesis. Gastroenterology 132(7):2557–2576PubMedCrossRefGoogle Scholar
  2. 2.
    Bruix J, Sherman M, American Association for the Study of Liver Diseases (2011) Management of hepatocellular carcinoma: an update. Hepatology 53(3):1020–1022PubMedCentralPubMedCrossRefGoogle Scholar
  3. 3.
    Bruix J, Sherman M, Llovet JM et al (2001) Clinical management of hepatocellular carcinoma. Conclusions of the Barcelona 2000 EASL conference. European Association for the Study of the Liver. J Hepatol 35(3):421–430PubMedCrossRefGoogle Scholar
  4. 4.
    Pang YY (2002) The Brisbane 2000 terminology of liver anatomy and resections. HPB 2000;2:333–39. HPB (Oxford) 4(2):99 author reply 99–100CrossRefGoogle Scholar
  5. 5.
    Ishak K, Baptista A, Bianchi L et al (1995) Histological grading and staging of chronic hepatitis. J Hepatol 22(6):696–699PubMedCrossRefGoogle Scholar
  6. 6.
    Mullen JT, Ribero D, Reddy SK et al (2007) Hepatic insufficiency and mortality in 1,059 noncirrhotic patients undergoing major hepatectomy. J Am Coll Surg 204(5):854–862 discussion 862–4PubMedCrossRefGoogle Scholar
  7. 7.
    Yamashita Y, Hamatsu T, Rikimaru T et al (2001) Bile leakage after hepatic resection. Ann Surg 233(1):45–50PubMedCentralPubMedCrossRefGoogle Scholar
  8. 8.
    Lok AS, McMahon BJ (2004) AASLD practice guidelines. Chronic hepatitis B: update of therapeutic guidelines. Rom J Gastroenterol 13(2):150–154PubMedGoogle Scholar
  9. 9.
    Lok AS, McMahon BJ (2007) Chronic hepatitis B. Hepatology 45(2):507–539PubMedCrossRefGoogle Scholar
  10. 10.
    Song TJ, Ip EW, Fong Y (2004) Hepatocellular carcinoma: current surgical management. Gastroenterology 127(5 Suppl 1):S248–S260PubMedCrossRefGoogle Scholar
  11. 11.
    Detroz B, Sugarbaker PH, Knol JA et al (1994) Causes of death in patients undergoing liver surgery. Cancer Treat Res 69:241–257PubMedCrossRefGoogle Scholar
  12. 12.
    Jarnagin WR, Gonen M, Fong Y et al (2002) Improvement in perioperative outcome after hepatic resection: analysis of 1, 803 consecutive cases over the past decade. Ann Surg 236(4):397–406 discussion 406–7PubMedCentralPubMedCrossRefGoogle Scholar
  13. 13.
    Simons JP, Hill JS, Ng SC et al (2009) Perioperative mortality for management of hepatic neoplasm: a simple risk score. Ann Surg 250(6):929–934PubMedCrossRefGoogle Scholar
  14. 14.
    Schindl MJ, Redhead DN, Fearon KC et al (2005) The value of residual liver volume as a predictor of hepatic dysfunction and infection after major liver resection. Gut 54(2):289–296PubMedCentralPubMedCrossRefGoogle Scholar
  15. 15.
    Bertoletti A, Gehring AJ (2006) The immune response during hepatitis B virus infection. J Gen Virol 87(Pt 6):1439–1449PubMedCrossRefGoogle Scholar
  16. 16.
    Klenerman P, Hill A (2005) T cells and viral persistence: lessons from diverse infections. Nat Immunol 6(9):873–879PubMedCrossRefGoogle Scholar
  17. 17.
    Webster GJ, Reignat S, Maini MK et al (2000) Incubation phase of acute hepatitis B in man: dynamic of cellular immune mechanisms. Hepatology 32(5):1117–1124PubMedCrossRefGoogle Scholar
  18. 18.
    Trobonjaca Z, Kroger A, Stober D et al (2002) Activating immunity in the liver. II. IFN-beta attenuates NK cell-dependent liver injury triggered by liver NKT cell activation. J Immunol 168(8):3763–3770PubMedCrossRefGoogle Scholar
  19. 19.
    Rapicetta M, Ferrari C, Levrero M (2002) Viral determinants and host immune responses in the pathogenesis of HBV infection. J Med Virol 67(3):454–457PubMedCrossRefGoogle Scholar
  20. 20.
    Rehermann B, Nascimbeni M (2005) Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol 5(3):215–229PubMedCrossRefGoogle Scholar
  21. 21.
    Wieland SF, Chisari FV (2005) Stealth and cunning: hepatitis B and hepatitis C viruses. J Virol 79(15):9369–9380PubMedCentralPubMedCrossRefGoogle Scholar
  22. 22.
    Lau JY, Wright TL (1993) Molecular virology and pathogenesis of hepatitis B. Lancet 342(8883):1335–1340PubMedCrossRefGoogle Scholar
  23. 23.
    Xie Y, Zhao H, Dai WS et al (2003) HBV DNA level and antigen concentration in evaluating liver damage of patients with chronic hepatitis B. Hepatobiliary Pancreat Dis Int 2(3):418–422PubMedGoogle Scholar
  24. 24.
    Yeo W, Johnson PJ (2006) Diagnosis, prevention and management of hepatitis B virus reactivation during anticancer therapy. Hepatology 43(2):209–220PubMedCrossRefGoogle Scholar
  25. 25.
    Yeo W, Chan PK, Zhong S et al (2000) Frequency of hepatitis B virus reactivation in cancer patients undergoing cytotoxic chemotherapy: a prospective study of 626 patients with identification of risk factors. J Med Virol 62(3):299–307PubMedCrossRefGoogle Scholar
  26. 26.
    Yeo W, Lam KC, Zee B et al (2004) Hepatitis B reactivation in patients with hepatocellular carcinoma undergoing systemic chemotherapy. Ann Oncol 15(11):1661–1666PubMedCrossRefGoogle Scholar
  27. 27.
    Nagamatsu H, Kumashiro R, Itano S et al (2003) Investigation of associating factors in exacerbation of liver damage after chemotherapy in patients with HBV-related HCC. Hepatol Res 26(4):293–301PubMedCrossRefGoogle Scholar
  28. 28.
    Zhong S, Yeo W, Schroder C et al (2004) High hepatitis B virus (HBV) DNA viral load is an important risk factor for HBV reactivation in breast cancer patients undergoing cytotoxic chemotherapy. J Viral Hepat 11(1):55–59PubMedCrossRefGoogle Scholar
  29. 29.
    Jang JW, Choi JY, Bae SH et al (2006) A randomized controlled study of preemptive lamivudine in patients receiving transarterial chemo-lipiodolization. Hepatology 43(2):233–240PubMedCrossRefGoogle Scholar

Copyright information

© Société Internationale de Chirurgie 2014

Authors and Affiliations

  • Gang Huang
    • 1
  • Wan Yee Lau
    • 1
    • 2
  • Feng Shen
    • 1
  • Ze-ya Pan
    • 1
  • Si-yuan Fu
    • 1
  • Yun Yang
    • 1
  • Wei-ping Zhou
    • 1
  • Meng-chao Wu
    • 1
  1. 1.The Third Department of Hepatic Surgery, Eastern Hepatobiliary Surgery Hospital, Eastern Hepatobiliary Surgery HospitalSecond Military Medical UniversityShanghaiChina
  2. 2.Faculty of Medicine, The Chinese University of Hong KongPrince of Wales HospitalShatinPeople’s Republic of China

Personalised recommendations