PURPOSE: To evaluate differences in the safety line of the future liver remnant plasma clearance rate of indocyanine green (RemK) necessary to prevent posthepatectomy liver failure (PHLF) associated with liver tumors and comorbidities. METHODS: The subjects of this retrospective study were patients who underwent trisectionectomy, hemihepatectomy, or sectionectomy, other than left lateral sectionectomy, between 2011 and 2018, at the Shizuoka Cancer Center. We analyzed the risk factors for PHLF grades B and C and then evaluated the RemK in these groups, according to various risk factors. RESULTS: A total of 463 patients were selected for the analyses. Among the patients with PHLF grades B and C, those with diabetes mellitus (DM), liver cirrhosis (LC), or hepatocellular carcinoma (HCC) had significantly higher RemK than those without these diseases. Multivariate analysis identified RemK ≤ 0.078, DM, and creatinine clearance rate < 60 mL/min as independent risk factors for PHLF grades B and C. CONCLUSIONS: Hepatectomy for patients with DM, HCC, or LC requires more functional hepatic reserve than that evaluated by RemK.
PURPOSE: To evaluate differences in the safety line of the future liver remnant plasma clearance rate of indocyanine green (RemK) necessary to prevent posthepatectomy liver failure (PHLF) associated with liver tumors and comorbidities. METHODS: The subjects of this retrospective study were patients who underwent trisectionectomy, hemihepatectomy, or sectionectomy, other than left lateral sectionectomy, between 2011 and 2018, at the Shizuoka Cancer Center. We analyzed the risk factors for PHLF grades B and C and then evaluated the RemK in these groups, according to various risk factors. RESULTS: A total of 463 patients were selected for the analyses. Among the patients with PHLF grades B and C, those with diabetes mellitus (DM), liver cirrhosis (LC), or hepatocellular carcinoma (HCC) had significantly higher RemK than those without these diseases. Multivariate analysis identified RemK ≤ 0.078, DM, and creatinine clearance rate < 60 mL/min as independent risk factors for PHLF grades B and C. CONCLUSIONS: Hepatectomy for patients with DM, HCC, or LC requires more functional hepatic reserve than that evaluated by RemK.
Authors: Pim B Olthof; Jimme K Wiggers; Bas Groot Koerkamp; Robert J Coelen; Peter J Allen; Marc G Besselink; Olivier R Busch; Michael I D'Angelica; Ronald P DeMatteo; T Peter Kingham; Krijn P van Lienden; William R Jarnagin; Thomas M van Gulik Journal: J Am Coll Surg Date: 2017-07-04 Impact factor: 6.113
Authors: Adel Abulkhir; Paolo Limongelli; Andrew J Healey; Osama Damrah; Paul Tait; James Jackson; Nagy Habib; Long R Jiao Journal: Ann Surg Date: 2008-01 Impact factor: 12.969