Quantified Risk Assessment for Major Hepatectomy via the Indocyanine Green Clearance Rate and Liver Volumetry Combined with Standard Liver Volume View Full Text


Ontology type: schema:ScholarlyArticle     


Article Info

DATE

2015-07

AUTHORS

Shin Hwang, Tae-Yong Ha, Gi-Won Song, Dong-Hwan Jung, Chul-Soo Ahn, Deok-Bog Moon, Ki-Hun Kim, Young-Joo Lee, Sung-Gyu Lee

ABSTRACT

BACKGROUND: Preoperative risk assessment for post-hepatectomy liver failure (PHLF) is essential for major hepatectomy. We intended to establish a standard liver volume (SLV) formula for Korean patients and validate the predictive power of the indocyanine green clearance rate constant (ICG-K) fraction of future remnant liver (FRL) (FRL-kICG) to total liver volume (TLV). METHODS: This study comprised 2 retrospective studies. Part I established SLV formula and acquired ICG pharmacokinetic data from 2155 living donors. In part II, FRL-kICG cutoff was determined using 723 patients who underwent right liver resection for hepatocellular carcinoma. RESULTS: In part I, the formula SLV (mL) = -456.3 + 969.8 × BSA (m(2)) (r = 0.707, r (2) = 0.500, p = 0.000) was derived with mean volume error of 10.5%. There was no correlation between TLV and ICG retention rate at 15 min. With a cutoff of 0.04 with hepatic parenchymal resection rate (PHRR) limit of 70%, 99.0% of our living donors were permissible for left or right hepatectomy. In part II, 25 hepatocellular carcinoma patients (3.5%) showed an FRL-kICG or SLV-corrected FRL-kICG <0.05. Of these, 4 (16 %) died of PHLF, whereas only 2 (0.3%) died in the other patient group with both an FRL-kICG and SLV-corrected FRL-kICG ≥ 0.05 (P = 0.000). CONCLUSIONS: The FRL-kICG appears to reliably predict PHLF risk quantitatively. We suggest FRL-kICG cutoffs of 0.04 and 0.05 with PHRR limits of 70% and 65% for normal and diseased livers, respectively. Further validation with large patient population in multicenter studies is necessary to improve FRL-kICG predictability. More... »

PAGES

1305-1314

References to SciGraph publications

Identifiers

URI

http://scigraph.springernature.com/pub.10.1007/s11605-015-2846-8

DOI

http://dx.doi.org/10.1007/s11605-015-2846-8

DIMENSIONS

https://app.dimensions.ai/details/publication/pub.1034812579

PUBMED

https://www.ncbi.nlm.nih.gov/pubmed/25947549


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