Clinical effect of liver cancer resection combined with selective decongestive devascularization in treatment of primary liver cancer complicated by portal hypertension

Objective To investigate the clinical effect of liver cancer resection combined with selective decongestive devascularization in the treatment of primary liver cancer complicated by portal hypertension. Methods A retrospective analysis was performed for the clinical data of 60 patients with primary liver cancer complicated by portal hypertension who were treated in The Second People's Hospital of Zhenjiang from March 2013 to February 2016. According to the surgical procedure,the patients were divided into group A( 32 patients) and group B( 28 patients). The patients in group A were given liver cancer resection combined with splenectomy,and those in group B were given liver cancer resection combined with selective decongestive devascularization. The patients' general status in the perioperative period were observed,and immune function parameters and liver function parameters were compared between the two groups before and after surgery,as well as the incidence of complications. The t- test was used for comparison of continuous data between groups,and the chi- square test was used for comparison of categorical data between groups. Results Compared with group A,group B had a significantly longer time of operation( 135. 27 ± 15. 13 min vs 118. 35 ± 12. 56 min,t =- 4. 733,P < 0. 001) and a significantly shorter length of hospital stay( 14.28 ± 2. 95 d vs 16. 37 ± 3. 42 d,t = 2. 516,P = 0. 007). At 1 month after surgery,group B had significantly higher levels of Ig G,Ig M,and Ig A than group A [( 14. 98 ± 3. 12) vs( 12. 51 ± 2. 75) 、( 2. 79 ± 1. 13) vs( 2. 25 ± 1. 02),( 2. 42 ± 0. 79) vs( 1. 87 ± 0. 82),t =- 3.260,- 1. 945,and- 2. 636,P < 0. 001, = 0. 028,and < 0. 005]. At 1 month after surgery,both groups showed significant increases in platelet count( t =- 89. 590 and- 20. 261,both P < 0. 001),and group A showed a significantly greater increase than group B [( 302. 46± 15. 08) × 109/ L vs( 80. 25 ± 5. 68) × 109/ L,t = 73. 481,P < 0. 001]. There were no significant differences in the incidence rates of postoperative complications between the two groups( 18. 75% vs 17. 86%,χ2= 0. 008,P = 0. 929). Conclusion Liver cancer resection combined with selective decongestive devascularization can improve liver function and maintain good immune function in patients,and therefore,it has an important clinical application value.