| Summary: | Objective To analyze the characteristics of perioperative liver function and complications in hepatocellular carcinoma (HCC) patients undergoing associating liver partition and portal vein ligation for staged hepatectomy (ALPPS, two-stage, hepatectomy and portal vein ligation). Methods Twenty-six patients undergoing ALPPS due to advanced HCC in our hospital from July 2014 to June 2017 were enrolled in this study. The indexes of liver function and their trends were observed in the perioperative period. The occurrence, development, treatment and outcomes of complications were also observed. Results The trend of liver function showed that after the first and second operations, alanine aminotransferase (ALT) level reached a peak on the first 1~2 d after surgery, and then decreased rapidly; total bilirubin (TB) reached the highest level on the 3rd~4th days after the first operation, maintained at a high level on the first 1 to 5 d after the second stage of surgery, and then gradually decreased to normal. One patient developed a "bilirubin-transaminase discrepancy" phenomenon in which the transaminase levels were gradually decreased while TB level was progressively elevated in 6 d after the secondary operation, and then developed into liver failure. In terms of complications, the highest incidence was pleural effusion, including 9 cases (34.6%, with 8 on the 3rd to 7th days after operation, and thoracic drainage in 1 case) in the first stage, and 12 cases (46.2%, with 10 cases on the 8th to 12th days postoperatively, and thoracic puncture drainage or drainage in 11 case) after the second operation. The incidence of infectious complications was 15.4% in the first phase and 26.9% after the second operation, and the lung infection was most common. Conclusion After ALPPS, transaminase and bilirubin show a trend of first rise and then falling within 1 week after operation. Pleural effusion is the most common complication after operation, and easy to occur in the first week after the first operation and second week after the second stage of surgery. Therefore, active prevention of lung infection is helpful to reducing the incidence of perioperative infection complications.
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