INFLUENCE OF SPLENOMEGALY ON PATIENTS UNDERGOING HEPATIC RESECTION FOR HEPATOCELLULAR CARCINOMA

This study is designed to study the influence of splenomegaly on the risk and outcome following hepatectomy in 75 patients with hepatocellular carcinoma (HCC). Spleen volume was measured by preoperative CT findings and divided into 3 groups, i.e., group A: less than 120cm3, group B: between 120 and 300cm3 and group C: more than 300cm3. In order of group A, B, and C, the frequency of association of liver cirrhosis or esophageal varix increased, but the platelet count decreased. There was no significant difference among three groups in preoperative ICGR15 value. Intraoperative bleeding volume in group C tended to be larger than other two groups, without significant difference. There were no significant differences in mobidity rate among 3 groups, 52.0% in group A, 41.7% in group B and 57.0% in group C. The 5-year cumulative survival rates were 49%, 54%, and 68% in group A, B, and C, respectively. There was no significant difference among these rates, but it tended to increase with the volume of the spleen. It is thought that the influence of spleen volume on the morbidity rate and surgical outcome can be negligible in patients undergoing hepatectomy for HCC.