Abstract: Objective This study was conducted to analyze influencing factors of delayed postoperative intestinal paralysis (DPOI) in patients with primary liver cancer (PLC) after radical hepatectomy and to construct and validate a nomogram prediction model based on risk factors for prediction. Method A total of 135 patients with PLC were encountered in our hospital between January 2022 and October 2023, and 51 patients received open surgery and 84 patients received laparoscopic hepatectomy. Systemic immune inflammation index (SII), and C-reactive protein/albumin ratio (CAR) were calculated. Univariate and multivariate Logistic regression analysis were applied to reveal risk factors, and receiver operating characteristic (ROC) curve was drawn for prediction efficacy. Result Of 135 patients with PLC in our series, DPOI occurred in 38 cases (28.2%) after hepatectomy; univariate Logistic regression analysis showed that ages, China liver cancer staging scheme (CNLC), operation, opioid use, SII and CAR were all related to DPOI happening (P＜0.05), and multivariate Logistic regression analysis demonstrated that CNLC(OR=5.273, 95%CI:2.195-12.663), operation (OR=3.046, 95%CI:1.721-5.388), opioid use (OR=4.457, 95%CI:2.166-9.168) and CAR (OR=5.856, 95%CI: 3.177-10.793) were all the independent risk factors for DPOI occurrence (P＜0.05); ROC analysis showed the AUC was 0.894(95%CI: 0.813-0.974, P＜0.05), with sensitivity of 89.5% and specificity of 90.7%, when the nomogram prediction model based on risk factors was applied for predicting DPOI occurrence. Conclusion Postoperative DPOI could occur in patients with PLC after radical resection of liver cancer, and early warning and intervention might improve the recovery.

Key words: Hepatoma, Radical hepatectomy, Delayed postoperative intestinal paralysis, Nomogram, Prediction