Hepatic venous pressure gradient in the assessment of portal hypertension before liver resection in patients with cirrhosis (Br J Surg 2012; 99: 855-863)

摘要

The value of portal hypertension (PHT) as a preoperative marker to select patients with liver cirrhosis and hepatocellular carcinoma for resectional liver surgery has been a source of debate. It may well be that the invasive nature of the measurement of hepatic venous portal gradient (HVPG) constitutes a limiting factor for its popularity. Probably as a consequence, the guidelines of the American Association for the Study of Liver Diseases (AASLD) and European Association for the Study of the Liver (EASL) only mention the presence of indirect signs of PHT (oesophageal varices or splenomegaly and thrombocytopenia) as a contraindication to surgical resection; they do not discuss the role of HVPG.