Original Article
Immediate postoperative low platelet count is associated with liver failure after partial hepatectomy in patients with hepatocellular carcinoma
Shiquan Sun, Liang Mao, Wenjun Jia, Tie Zhou, Yudong Qiu
Published 2016-05-28
Cite as Chin J Hepatobiliary Surg, 2016, 22(5): 294-298. DOI: 10.3760/cma.j.issn.1007-8118.2016.05.003
Abstract
ObjectiveTo investigate the correlation between immediate postoperative platelet count with liver failure after partial hepatectomy in patients with hepatocellular carcinoma.
MethodsThe clinical data of 71 patients with hepatocellular carcinoma who underwent liver resection at the Hepatopancreatobiliary Surgery Department of Nanjing Drum Tower Hospital from July 2013 to August 2015 were retrospectively analyzed. The clinical diagnosis was confirmed by pathology of the resected specimens. Based on postoperative platelet count within 2 h, the patients were divided into the low platelet count (PLT<100×109/L= group (n=24, 33.8%) and the normal platelet count (PLT≥100×109/L) group (n=47, 66.2%). The correlations between immediate postoperative platelet count with serum indexes including serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (Tbil) and direct bilirubin (Dbil) were analyzed, and the incidences of posthepatectomy liver failure was also evaluated in these two groups.
ResultsThere was no re-operation and perioperative death in this study. Among the 71 patients, 25 patients (35.2%) developed postoperative complications (grade Ⅰ to Ⅲ), and 8 patients (11.3%) suffered from postoperative liver failure (grade A). When compared with the normal platelet count group, the low platelet count group had significantly increased risks of postoperative liver failure (29.2% vs 2.1%, χ2=11.618, P<0.05), increased postoperative peaks of ALT, AST, Tbil and Dbil levels [(462.5±135.7)U/L vs (307.9±192.6)U/L, (440.0±163.3)U/L vs (265.8±155.8)U/L, (29.5±9.1)μmol/L vs (17.9±8.8)μmol/L, t=3.507, 4.385, 5.129, P<0.05, respectively] and longer normalization time of liver function. Multiple Logistic regression analyses revealed that an immediate postoperative low platelet count was an independent risk factor of posthepatectomy liver failure.
ConclusionsThe platelet count was associated with the incidence of postoperative liver failure after partial liver resection in patients with hepatocellular carcinoma. Patients with an immediate postoperative low platelet count suffered from a high incidence of posthepatectomy liver failure and delayed liver function recovery.
Key words:
Hepatocellular carcinoma; Liver resection; Platelet count; Liver regeneration
Contributor Information
Shiquan Sun
Department of Hepatobiliary-pancreatic Surgery, Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing 210008, China
Liang Mao
Wenjun Jia
Tie Zhou
Yudong Qiu
