{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T04:55:11Z","timestamp":1784868911474,"version":"3.55.0"},"reference-count":41,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2014,5,27]],"date-time":"2014-05-27T00:00:00Z","timestamp":1401148800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Hepato Biliary Pancreat"],"published-print":{"date-parts":[[2014,9]]},"abstract":"Abstract\u2003<\/jats:title>Surgical resection is not indicated in patients with portal hypertension in the current guideline of B<\/jats:styled-content>arcelona Clinic Liver Cancer (BCLC<\/jats:styled-content>) stage. We report a systematic review and meta\u2010analysis to determine the impact of clinically significant portal hypertension on survival in patients with hepatocellular carcinoma (HCC<\/jats:styled-content>) following hepatectomy. Searched data in PubMed<\/jats:styled-content>, EMBASE<\/jats:styled-content>, and the Cochrane Library were reviewed and 11 publications were included in the meta\u2010analysis. The inclusion criteria of clinically significant portal hypertension were esophageal varices and\/or thrombocytopenia with splenomegaly. Pooled data were extracted and computed into odds ratios (ORs<\/jats:styled-content>) for clinical outcome and hazard ratios (HRs<\/jats:styled-content>) for overall survival. The final pooled data were composed of 2,285 patients. There were 775 patients with clinically significant portal hypertension (PHT<\/jats:styled-content> group) and 1,510 patients without clinically significant portal hypertension (non\u2010PHT<\/jats:styled-content> group). Pooled proportion of mortality was 6.1% (95% confidence interval [CI]<\/jats:styled-content> 0.032\u20130.116) in PHT<\/jats:styled-content> group and 2.8% (95% CI<\/jats:styled-content> 0.014\u20130.054) in the non\u2010PHT<\/jats:styled-content> group. The pooled proportion of morbidity was 41.7% (95% CI<\/jats:styled-content> 0.274\u20130.575) in PHT<\/jats:styled-content> group and 34.7% (95% CI<\/jats:styled-content> 0.243\u20130.467) in non\u2010PHT<\/jats:styled-content> group. Pooled data confirmed a significantly higher postoperative mortality in the PHT<\/jats:styled-content> group, with OR<\/jats:styled-content> 3.02 (P<\/jats:italic> < 0.001). The PHT<\/jats:styled-content> group also demonstrated significantly higher occurrence of postoperative complications (OR<\/jats:styled-content> 1.39, P<\/jats:italic> = 0.008), liver\u2010related morbidity (OR<\/jats:styled-content> 3.10, P<\/jats:italic> < 0.00001), and liver failure (OR<\/jats:styled-content> 2.14, P<\/jats:italic> = 0.0005) compared to the non\u2010PHT<\/jats:styled-content> group. According to the overall survival, pooled analysis demonstrated that the PHT<\/jats:styled-content> group demonstrated poorer survival than the non\u2010PHT<\/jats:styled-content> group (HR<\/jats:styled-content> 1.48, P<\/jats:italic> = 0.007). The analyses support significantly higher rates of postoperative mortality, complications, liver\u2010related morbidity, liver failure, and poorer overall survival in PHT group compared with the non\u2010PHT<\/jats:styled-content> group. Surgical resection should be selected carefully with strict surgical strategy in patients with clinically significant portal hypertension when surgical resection is planned.<\/jats:p>","DOI":"10.1002\/jhbp.124","type":"journal-article","created":{"date-parts":[[2014,5,28]],"date-time":"2014-05-28T00:14:54Z","timestamp":1401236094000},"page":"639-647","source":"Crossref","is-referenced-by-count":41,"title":["Influence of clinically significant portal hypertension on surgical outcomes and survival following hepatectomy for hepatocellular carcinoma: a systematic review and meta\u2010analysis"],"prefix":"10.1002","volume":"21","author":[{"given":"Sae Byeol","family":"Choi","sequence":"first","affiliation":[{"name":"Department of Surgery Korea University Guro Hospital Korea University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyun Jung","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Korea University College of Medicine 126\u20101 Anam Dong, Seong Buk Gu Seoul 136\u2010705 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tae Jin","family":"Song","sequence":"additional","affiliation":[{"name":"Department of Surgery Korea University Guro Hospital Korea University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Sik","family":"Ahn","sequence":"additional","affiliation":[{"name":"Department of Preventive Medicine Korea University College of Medicine 126\u20101 Anam Dong, Seong Buk Gu Seoul 136\u2010705 Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Yong","family":"Choi","sequence":"additional","affiliation":[{"name":"Department of Surgery Korea University Guro Hospital Korea University College of Medicine Seoul Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2014,5,27]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1007122"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.510300629"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199603143341104"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.1800600817"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-004-0949-9"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ssu.2980090404"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0016-5085(96)70070-7"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2005.05.009"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2010.06.004"},{"key":"e_1_2_6_11_1","volume-title":"The Newcastle\u2010Ottawa Scale (NOS) for assessing the quality of nonrandomised studies in meta\u2010analyses","author":"Wells GA","year":"2006"},{"key":"e_1_2_6_12_1","first-page":"553","article-title":"The adverse effect of indirectly diagnosed portal hypertension on the complications and prognosis after hepatic resection of hepatocellular carcinoma","volume":"12","author":"An M","year":"2006","journal-title":"Korean J Hepatol"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-005-0524-9"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1478-3231.2010.02436.x"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181b977a5"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1111\/liv.12199"},{"key":"e_1_2_6_17_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2008.02.091"},{"key":"e_1_2_6_18_1","doi-asserted-by":"publisher","DOI":"10.1245\/s10434-008-9880-7"},{"key":"e_1_2_6_19_1","first-page":"2269","article-title":"Characteristics and surgical outcome of HCC patients with low platelet count","volume":"59","author":"Kondo K","year":"2012","journal-title":"Hepatogastroenterology"},{"key":"e_1_2_6_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jamcollsurg.2011.01.004"},{"key":"e_1_2_6_21_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v17.i46.5083"},{"key":"e_1_2_6_22_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1477-2574.2012.00594.x"},{"key":"e_1_2_6_23_1","first-page":"97","volume-title":"Cochrane handbook for systematic reviews of interventions","author":"Deeks JJ","year":"2006"},{"key":"e_1_2_6_24_1","doi-asserted-by":"publisher","DOI":"10.1002\/hep.20933"},{"key":"e_1_2_6_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0168-8278(01)00130-1"},{"key":"e_1_2_6_26_1","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v19.i8.1193"},{"key":"e_1_2_6_27_1","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-200211000-00010"},{"key":"e_1_2_6_28_1","doi-asserted-by":"publisher","DOI":"10.1136\/gut.2005.069153"},{"key":"e_1_2_6_29_1","doi-asserted-by":"publisher","DOI":"10.1053\/j.gastro.2012.10.001"},{"key":"e_1_2_6_30_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jhep.2011.06.027"},{"key":"e_1_2_6_31_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1351782"},{"key":"e_1_2_6_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1072-7515(98)00240-3"},{"key":"e_1_2_6_33_1","doi-asserted-by":"publisher","DOI":"10.1097\/01.sla.0000141195.66155.0c"},{"key":"e_1_2_6_34_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-011-1161-0"},{"key":"e_1_2_6_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3182111195"},{"key":"e_1_2_6_36_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.21738"},{"key":"e_1_2_6_37_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20140"},{"key":"e_1_2_6_38_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0033-1351783"},{"key":"e_1_2_6_39_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0b013e3181bd582b"},{"key":"e_1_2_6_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/lt.20040"},{"key":"e_1_2_6_41_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11605-009-0903-x"},{"key":"e_1_2_6_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2407-14-38"}],"container-title":["Journal of Hepato-Biliary-Pancreatic Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1002%2Fjhbp.124","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/jhbp.124","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,6]],"date-time":"2023-10-06T08:07:39Z","timestamp":1696579659000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/jhbp.124"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,5,27]]},"references-count":41,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2014,9]]}},"alternative-id":["10.1002\/jhbp.124"],"URL":"https:\/\/doi.org\/10.1002\/jhbp.124","archive":["Portico"],"relation":{},"ISSN":["1868-6974","1868-6982"],"issn-type":[{"value":"1868-6974","type":"print"},{"value":"1868-6982","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,5,27]]}}}