S418 Electronic Posters (EP01A-EP01E) - Liver

General Hospital were analyzed retrospectively. Patients Methods: From January 2015- June 2017, 12 patients were
with extrahepatic metastases were excluded. included. 7 patients were females and 5 patients wre
Results: 112 patients underwent surgery for synchronous male.The cause of NCPH— EHPVO-9, NCPF- 3. The in-
CLM; 96 (85.7%) and 16 (14.3%) patients underwent dications of surgery were portal hypertension in 9 patients,
staged and simultaneous resections respectively. growth retardation in 2 and abdominal discomfort due to
Total median operative time for simultaneous is 280 huge splenomegaly in 1 patient.
(95% CI 75 - 400) minutes, longer than 197.5 (95% CI 75 - Results: All 12 patients had undergone proximal sple-
480) minutes for staged resection (p = 0.0072). Median norenal shunt (PSRS).2 patients had shunt thrombosis with
blood loss was 250mL (95% CI 0 - 2500) in staged development of oesophageal varices for which medical
resection, higher than 25mL (0 to 1500) in simultaneous management and endoscopic variceal ligation were carried
(p = 0.056). Median length of stay was 14 (95 % CI 5 - 74) out with continuation of anticoagulat therapy.1 patient died
and 12 (95% CI 7 - 29) days for staged and simultaneous of myocardial infarction 6 months following surgery.
resections respectively (p = 0.115). Conclusion: Surgery in NCPH is reserved for patients with
Complication rates were similar between both groups: 15 portal hypertension related complicationswho fail medical
of 96 patients (15.6%) from staged resection experienced and endoscopic treatment.Results after shunt surgery de-
17 complications vs. 6 of 16 (37.5%) from simultaneous pends on the specific disease(EHPVO showing the best
resection experienced 6 complications (p = 0.076). No long term patency), preoperative liver function status and
mortality was observed. post operative patency of the shunts.
There were no statistical differences in overall and
recurrence free survival between both groups.
Conclusions: Simultaneous resection results in similar EP01C-054
perioperative and oncological outcomes compared to
INTRAOPERATIVE ICG TEST
staged resection and is an acceptable alternative for patients
with resectable synchronous CLM. PREDICTS POSTOPERATIVE
COMPLICATIONS IN PATIENTS
Table 1[Complications]
UNDERGOING A STAGED HEPATIC
Outcomes Staged Simultaneous p-value RESECTION
(n[96) (n[16)
K. Horisberger1, F. Roessler1,2, D. Raptis1, C. Oberkofler1,
Complications, n
C. Tschuor1, P. Sanchez Velazquez1, H. Petrowsky1 and
Yes 15 6 0.076 P. -A. Clavien1
1
No 81 10 University Hospital Zurich, and 2Cantonal Hospital
Wound Infections 1 2 ns Baden, Switzerland
Pulmonary 4 0 Introduction: Sufficient function of the future liver remnant
Cardiac 3 1 ns is requisite to avoid post-hepatectomy liver failure (PHLF).
Different diagnostic tools help to estimate the volume and
Hepatic Abscess/ 2 2 ns
Fluid function. However, a tool to evaluate reliably the functional
capacity of future liver remnant (FLR) is missing.
Hepatic Failure/ 3 0
Insufficiency
Methods: Between September 2015 and May 2017, all
consecutive patients undergoing staged hepatectomies
Others 4 1 ns
received MRI or CT-scans to assess sFLR; 99mTc-Iodida
scan was performed to assess the functional capacity. Pre-
EP01C-053 and intraoperative Indocyaningreen tests (ICGTest) were
ROLE OF SURGICAL SHUNTS IN NON performed to compare the different tests and with the
outcome. Postoperative complications were graded and
CIRRHOTIC PORTAL HYPERTENSION calculated according to Clavien-Dindo and Comprehensive
IN THE ERA OF ADVANCE GASTRO- Complication Index (CCI).
INTESTINAL ENDOSCOPY Results: 15 patients were included, median age 57. 9 pa-
D. Bora tients hat major complications ( grade III); median CCI
Gastro-Intestinal and Hepato-Biliary Surgery, Apollo was 22.6. One patient died postoperatively.
Hospital, India Median preoperative R15 was 5 [IQR 2.2 - 8.8]. No sig-
Introduction: Non cirrhotic portal hypertension (NCPH ) nificant correlation was found between sFLR, 99mTc-Iodida
is a heterogenous group of vascular diseases that lead to scan and R15. Preoperative R15, 99mTc-Iodida scan and sFLR
portal hypertension with normal or mildly elevated Hepatic did not correlate to CCI. Intraoperative R15 was median 11.4
venous pressure gradient and preserved liver synthetic [IQR 5.3 - 17]; it correlated to end-of hospitalization CCI
function.It is a common cause of portal hypertension in (p=0.05) and to 90 day CCI (p=0.0036). ROC curve analysis
children (upto 70%)and young adults in India and other revealed that a cutoff value of 11.4 for intraoperative R15 was
developing countries. Morbidity is mainly related to vari- able to identify postoperative major complications.
ceal bleeding, hypersplenism, growth retardation and portal Discussion: Intraoperative ICGtesting allows real-time
biliopathy.The main disease producing NCPH are EHPVO monitoring of the functional capacity of future remnant
and NCPF.The main indication for surgery in NCPH is liver by clamping of arterial and porto-venous inflow of
prevention of variceal bleeding, growth retardation, portal the part to be resected. We herewith propose a cutoff of
biliopathy, symptomatic hypersplenism and abdominal intraoperative ICG that will be validated in a larger
discomfort due to massive splenomegaly. cohort. It could help to prevent disastrous postoperative
consequences.

HPB 2018, 20 (S2), S333eS504

Downloaded for Dai Hoon Han ([email protected]) at Yonsei University College of Medicine from ClinicalKey.com by Elsevier on
November 02, 2023. For personal use only. No other uses without permission. Copyright ©2023. Elsevier Inc. All rights reserved.