Analysis Of Risk Factors For Liver Dysfunction After Hepatectomy In Patients With Primary Liver Cancer

Objective:Our aim was to analyze the predictive factors of liver dysfuncti on after partial hepatectomy in patients with primary liver cancer(P LC).Method:376 patients with PLC who underwent liver resection were retrospeetively analzyed in the first hospital of Jilin university between January 2012 to April 2015.Patients were divided into liver dysfunction group(n=256)and those who survived without liver damaging were designated as normal liver function group(n=229).Demographic and clinical characteristics(age,sex,liver cirrhosis,intraoperative blood loss,tumor diameter,number of tumors,operation time,number of resected hepatic segments,FIB-4,Model for end-stage liver disease(MELD),tumor differentiation,Child-Pugh classification,TNM sta-ge)and laboratory test(white blood cell,neutrophils,hemoglobin,platelet,platelet/lymphocyte ratio(PLR),neutrophils/lymphocyte ratio(NLR),prothrombin time(PT),international normalized ratio(INR),lymphocyte,prothrombin time activity(PTA%),blood urea nitrogen(BUN),creatinine(Cr),serum sodium(Na),alanine aminotrans ferase(ALT),aspartate aminotransferase(AST),glutamyltranspetidase(GGT),alkaline phosphatase(ALP),albumin(ALB),cholinesterase(CHE),Total protein(TP),conjugated bilirubin(CBIL),and total bilirubin(TBIl),Alpha fetoprotein(AFP)Were collected to screen the risk factors for liver dysfunction after hepatectomy by univariate and multiple regress analyses with SPSS23.0.Results:All the 376 patients were followed up for 7 days after operation,256 of them were liver dysfunction,resulting in a mortality rate of 60.08%.Univariate analysis showed that Child-Pugh classific-ation,DBIL,TBIL,TP,ALB,CHE,HGB,PLR were risk factors affecting the liver dysfunction(P=0.039,0.00,0.036,0.003,<0.001,<0.00,0.011 and 0.038,respectively);Multivariate logistic regression analysis showed that ALB,TBIL and PLR were independent risk factors for the liver dysfunction after PLC resection.[P=0.014,<0.001,0.026 respectively;OR(95%CI)= 1.037(1.007—1.068)?0.871(0.828-0.916)?0.996(0.992-1.000)respectively.] Conclusion:1.The indexes of Child-Pugh classification,DBIL,TBI-L,TP,ALB,CHE,HGB,PLR are related to the morbidity of liver dysfunction after PLC resection.2.Hypoproteinemia,decreased PLR and elevated total bilirubin may be an independent risk factor for liver dysfunction after PLC resection...