Abstract
Background
Portal hypertension after hepatectomy is associated with impaired postoperative recovery.
Terlipressin decreased portal vein pressure in patients with variceal bleeding and
improved patient survival, but the role of postoperative terlipressin treatment for
patients who underwent liver resection is not clear.
Methods
We determined the effect of terlipressin on portal vein pressure in patients with
portal vein pressure >12 mmHg after hepatectomy. If portal vein pressure was decreased
(ie, Responders), a continuous infusion of terlipressin at 2 mg/day for 4 days was
given. The incidence of posthepatectomy liver failure, abdominal drainage, acute kidney
injury, operative complications, and side-effects of terlipressin in the Responders
were compared with those whose portal vein pressure did not decrease (ie, non-Responders)
and patients whose portal vein pressure was ≤12 mmHg after hepatectomy (low portal
vein pressure group).
Results
We recruited 110 patients, 65 of whom were eligible for terlipressin administration.
Portal vein pressure decreased in 46 patients (71%) with the mean portal vein pressure
decreasing from 15.8 ± 2.6 mmHg to 14.3 ± 2.9 mmHg (P < .001). The median [interquartile range] postoperative abdominal drainage for the
first 3 postoperative days was less in the Responders than in the non-Responders (350
mL [228–573] vs 730 mL [330–980]; P = .004). Incidence of posthepatectomy liver failure in the Responders was less than
the non-Responders (26% vs 53%, P = .04). Acute kidney injury, operative complications, and side-effects of terlipressin
were not different between groups.
Conclusion
Terlipressin decreased posthepatectomy portal vein pressure and may decrease the incidence
of posthepatectomy liver failure and postoperative abdominal drainage (NCT03352349).
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Article info
Publication history
Published online: February 26, 2020
Accepted:
January 16,
2020
Footnotes
Xiao-Long Li, Xiao-Dong Zhu, and Nan Xiao contributed equally to this work.
Identification
Copyright
© 2020 Elsevier Inc. All rights reserved.
