Azoulay, DanielRamos Rubio, EmilioCasellas Robert, MargaridaSalloum, ChadyLladó Garriga, LauraNadler, RoyBusquets Barenys, JuliCaula Freixa, CeliaMils, KristelLópez Ben, SantiagoFigueras Felip, JoanLim, Chetana2021-06-142020-10-080168-8278https://hdl.handle.net/2445/178335Background & Aims: Liver resection (LR) in patients with hepatocellular carcinoma (HCC) and clinically significant portal hypertension (CSPH) defined as a hepatic venous pressure gradient (HVPG) >−10 mmHg is not encouraged. Here, we reap praised the outcomes of patients with cirrhosis and CSPH who underwent LR for HCC in highly specialised liver centres. Methods: This was a retrospective multicentre study from 1999 to 2019. Predictors for postoperative liver decompensation and textbook outcomes were identified. Results: In total, 79 patients with a median age of 65 years were included. The Child-Pugh grade was A in 99% of patients, and the median model for end-stage liver disease (MELD) score was 8. The median HVPG was 12 mmHg. Major hepatectomies and laparoscopies were performed in 28% and 34% of patients, respectively. Ninety-day mortality and severe morbidity rates were 6% and 27%, respectively. Postoperative and persistent liver decompensation occurred in 35% and 10% of patients at 3 months. Predictors of liver decompensation included increased preoperative HVPG (p = 0.004), increased serum total bilirubin (p = 0.02), and open approach (p = 0.03). Of the patients, 34% achieved a textbook outcome, of which the laparoscopic approach was the sole predictor (p = 0.004). The 5-year overall survival and recurrence-free survival rates were 55% and 43%, respectively. Conclusions: Patients with cirrhosis, HCC and HVPG >−10 mmHg can undergo LR with acceptable mortality, morbidity, and liver decompensation rates. The laparoscopic approach was the sole predictor of a textbook outcome.8 p.application/pdfengcc-by-nc-nd (c) Azoulay, Daniel et al., 2020https://creativecommons.org/licenses/by-nc-nd/4.0/HepatectomiaHipertensió portalPeríode postoperatoriCirrosi hepàticaHepatectomyPortal hypertensionPostoperative periodHepatic cirrhosisinfo:eu-repo/semantics/article7065272021-06-14info:eu-repo/semantics/openAccess2673462733294830