Preoperative Factors in Liver Surgery

The included demographic features were age, sex, and Child–Pugh classification (scores of 5–6, 7–9, and 10–15 for classes A, B, and C, respectively). Method of surgery, whether anatomic splenectomy was performed, BMI at admission: BMI = weight (kg)/height (m²), diabetes mellitus, hypertension, smoking history (one or more cigarettes daily for 6 months), duration of surgery, intraoperative bleeding and splenomegaly grade. Patients fasted for 8–12 h, and 5 mL of venous blood was extracted at 8 am before the procedure. Automatic hemacytometer (XN-9000, Sysmex Corporation, Japan) was used to detect the level of WBC, RBC, hemoglobin (HGB), and hematocrit (HCT) by counter method. Activated partial thromboplastin time (APTT), prothrombin time (PT), and fibrinogen (FIG) were determined using the coagulation method, and D-dimer was determined using immunoturbidimetry. Automatic biochemical analyzer (7600-010, Hitachi, Ltd. Japan) was employed to detect the level of alanine transaminase (ALT), while aspartate transaminase (AST) was determined using the rate method. Albumin (ALB) concentration was measured using bromocresol green method, while total bilirubin (TBIL) was measured using the diazo method. Blood urea nitrogen (BUN) level was ascertained using HMMPS method, and serum creatinine (CER) was determined using the uric acid method. The dynamics of blood flow [portal vein diameter (PVD), splenic vein diameter (SVD), portal vein flow (PVF), and portal vein velocity PVV)] were determined using color Doppler ultrasound (ACUSON Antares, Siemens AG, Germany) with 5.0 MHz wide-screen concave array probe.