Introduction : Surgical resection is considered to be the first therapeutic option for HCC. To minimize the postoperative complication, thorough evaluation of functional reserve is crucial. Influence of portal venous pressure on postoperative outcome of HCC resection has been reported controversially. This study was aimed to find out the effect of intraoperative portal venous pressure on outcome of liver resection for HCC.

Methods : 89 patients with HCC who underwent liver resection were enrolled in this study. Portal venous pressure was evaluated by intraoperative direct measurement. Patients were divided into two groups; high PVP group (≥ 15mmHg) and low PVP (< 15mmHg). Postoperative liver decompensation was evaluated by development of severe ascites, hyperbilirubinaemia and/or encephalopathy. Association between intraoperative portal venous pressure and postoperative liver decompensation was analyzed.

Results : Among 89 patients, 65 patients (73%) were in high PVP group and 24 patients (27%) were in the low PVP group. Overall liver decompensation was observed in 31patients (34.8%). 12.5% of those were in low PVP group and 43.1% were in high PVP group. (χ² = 7.2, p value 0.007). Majority of the patient decompensated in the form of severe ascites. 6 patients progressed to postoperative liver failure.

Conclusions : HCC patients with increased portal venous pressure could have higher risk of developing postoperative liver decompensation and postoperative liver failure.