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Abstract：
The influence of liver fibrosis on the rate of liver regeneration and complications following ALPPS has yet to be fully understood. This study aimed to scrutinize the effects of liver fibrosis on the postoperative complications, and prognosis subsequent to ALPPS. Clinical data were collected from patients with primary liver cancer who underwent ALPPS at Peking Union Medical College Hospital between May 2014 and October 2022. The degree of liver fibrosis was assessed using haematoxylin-eosin staining and Sirius red staining. This study encompassed thirty patients who underwent ALPPS for primary liver cancer, and there were 23 patients with hepatocellular carcinoma, 5 with cholangiocarcinoma, and 2 with combined hepatocellular-cholangiocarcinoma. The impact of severe liver fibrosis on the rate of liver regeneration was not statistically significant (P = 0.892). All patients with severe complications belonged to the severe liver fibrosis group. Severe liver fibrosis exhibited a significant association with 90 days mortality (P = 0.014) and overall survival (P = 0.012). Severe liver fibrosis emerges as a crucial risk factor for liver failure and perioperative mortality following the second step of ALPPS. Preoperative liver function impairment is an important predictive factor for postoperative liver failure.
摘要：
肝纤维化对ALPPS后肝再生率和并发症的影响尚未完全了解。本研究旨在研究肝纤维化对术后并发症的影响，以及ALPPS后的预后。收集2014年5月至2022年10月在北京协和医院接受ALPPS治疗的原发性肝癌患者的临床数据。使用苏木精-伊红染色和天狼星红染色评估肝纤维化的程度。这项研究包括30例原发性肝癌患者接受ALPPS治疗，有23例肝细胞癌患者，5患有胆管癌，2合并肝细胞-胆管癌。重度肝纤维化对肝再生率的影响无统计学意义(P=0.892)。所有严重并发症患者均属于重度肝纤维化组。严重肝纤维化与90天死亡率（P=0.014）和总生存率（P=0.012）显着相关。严重的肝纤维化是ALPPS第二步后肝衰竭和围手术期死亡率的关键危险因素。术前肝功能损害是术后肝功能衰竭的重要预测因素。
