The Correlation Study Between Hemodynamic Changes Of Portal Vein System ALPPS Stage Ⅰ And Liver Regeneration And Complications In HCC Patients

Objective: The aim of this study is to study the correlation between the associating liver partition and portal vein ligation for staged hepatectomy(ALPPS)I stage hemodynamic changes of portal vein system and postoperative future liver remnant(FLR)regeneration,as well as the correlation of the postoperative complications and postoperative liver failure.Methods: The clinical data of 24 patients with primary hepatocellular carcinoma who completed the ALPPS-I stage were collected.Color Doppler ultrasonography was used to measure the changes of portal vein hemodynamics before and after liver partition in ALPPS-I stage and on the 1st,3rd,5th,7th and10 th day after operation.Then analyze the correlation between ALPPS-Ⅰ stage postoperative portal vein hemodynamic changes with the regeneration of FLR,postoperative complications and postoperative liver failure.Results: The blood flow of the left portal vein after ALPPS-I stage was significantly higher than that before operation(F=7.218,P=0.003),but there was no significant change in the blood flow of the main portal vein(F = 0.957,P =0.468).The FLR had varying degrees of hyperplasia compared with that before operation,and the proliferation rate was 47.20% ±23.54%,the kinetic growth rates(KGR)was 21.51%±11.57%.According to Pearson correlation analysis,the mean increase of left portal blood flow after stage I operation and the increment of blood flow on the 3rd and 10 th day after operation were positively correlated with KGR,which were(P=0.018,r=0.478),(P=0.038,r=0.426)and(P=0.013,r=0.498),respectively.In stage I,the blood flow of the left portal vein was moderately positively correlated with the incidence of postoperative complications(P=0.043,r =-0.417),but not with liver failure.There was no significant correlation between the increment of main portal vein blood flow and KGR,postoperative complications and the occurrence of liver failure(P > 0.05).Conclusion: The increase of left portal vein blood flow after ALPPS-I may have a positive correlation with residual liver hyperplasia and a negative correlation with postoperative complications.