scholarly journals Perioperative assessment of indocyanine green elimination rate accurately predicts postoperative liver failure in patients undergoing hepatectomy

2020 ◽  
Author(s):  
Yuki Sunagawa ◽  
Suguru Yamada ◽  
Yoshiyasu Kato ◽  
Fuminori Sonohara ◽  
Hideki Takami ◽  
...  
Keyword(s):  
Liver Failure ◽  
Indocyanine Green ◽  
Elimination Rate ◽  
Postoperative Liver Failure ◽  
Perioperative Assessment

Early detection of liver failure after hepatectomy by indocyanine green elimination rate measured by pulse dye-densitometry

2006 ◽  
Vol 13 (6) ◽  
pp. 543-548 ◽  
Author(s):  
Hiroyuki Sugimoto ◽  
Osamu Okochi ◽  
Masashi Hirota ◽  
Naohito Kanazumi ◽  
Shuji Nomoto ◽  
...  
Keyword(s):  
Early Detection ◽  
Liver Failure ◽  
Indocyanine Green ◽  
Elimination Rate

scholarly journals Evaluation of Liver Function Tests to Predict Operative Risk in Liver Surgery

HPB Surgery ◽  
1995 ◽  
Vol 9 (1) ◽  
pp. 13-18 ◽  
Author(s):  
Thomas Zoedler ◽  
Christoph Ebener ◽  
Heinz Becker ◽  
Hans D. Roeher
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Liver Tissue ◽  
Elimination Rate ◽  
Liver Function Tests ◽  
Operative Risk ◽  
Postoperative Liver Failure ◽  
Resection Rate ◽  
Function Tests ◽  
Galactose Elimination Capacity

Despite numerous studies in the past it is not possible yet to predict postoperative liver failure and safe limits for hepatectomy. In this study the following liver function tests ICG-ER (indocyaninegreen elimination rate), GEC (galactose elimination capacity) and MEGX-F (monoethylglycinexylidid formation) are examined with regard to loss of liver tissue and prediction of operative risk. Liver function tests were assessed in 20 patients prior to liver resection and on the 10th. postoperative day. Liver and tumor volume were measured by ultrasound and pathologic specimen and the parenchymal resection rate was calculated. In patients without cirrhosis (n = 10) ICG-ER and MEGX-F remained unchanged after resection, GEC was reduced but did not correspond to the resection rate. Patients with cirrhosis (n = 10) had a significantly lower ICG-ER and GEC before resection than patients without cirrhosis. After resection these tests were unchanged. Patients with liver related complications and cirrhosis (n = 5) had lower ICG-ER and GEC than patients with cirrhosis and no complications. In the postoperative course all liver function tests in these patients were significantly lower compared to preoperative results. Comparing liver function tests ICG serves best to indicate postoperative liver failure. Liver function tests do not correspond with loss of liver tissue.

Η αξιολόγηση της κάθαρσης του πράσινου της ινδοκυανίνης (ICG) προεγχειρητικά ως μέθοδος ελέγχου της ηπατικής λειτουργίας μετά ηπατεκτομή

2013 ◽  
Author(s):  
Μιχαήλ Δέρπαπας
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Vena Cava ◽  
Normal Liver ◽  
Postoperative Liver Failure ◽  
Remnant Liver ◽  
Total Blood ◽  
Hepatic Reserve ◽  
Icg Clearance ◽  
Residual Liver Function

Purpose: Liver failure is a major cause of early mortality followinghepatectomy. The future-remnant liver function is an important factor whenassessing the risk for postoperative liver impairment. Several techniques havebeen established for this evaluation, including the ICG test. Aim of the study isto evaluate the ICG clearance in patients scheduled for liver resectionregarding perioperative and postoperative risk factors.Methods: Thirty-one patients, scheduled for liver resection, underwent theICG test. Peri-operative and postoperative variables were recorded andanalyzed using non-parametric tests.Results: Procedures extended from wedge excisions to extendedhepatectomies. Major complications included 1 case of a non-ST elevationmyocardial infarct, 1 case of inferior vena cava thrombosis, 2 cases of liverinsufficiency and 1 case of renal failure. Two patients died due to myocardialinfarction and postoperative liver failure respectively. PDR was foundpositively correlated with total blood loss, transfusion and operation duration.Conclusions: The role of residual liver function and particularly the hepaticreserve assessment on liver surgery may be of most benefit in the routinestratification of risk, enabling surgical procedures to be performed with safety.In this study, the ICG clearance markers were found significantly correlated with perioperative risk factors in histologically „normal‟ liver parenchyma.Interpretation of ICG clearance results may appraise in these patients aninadequate hepatic reserve in the remaining parenchyma postoperatively.Thus, in addition to CT volumetry, functional assessment of the hepaticreserve with ICG may persuade the preoperative planning and preventpostoperative liver failure.

Relationship between platelet count and hepatic failure and residual liver regeneration after hemihepatectomy in patients with hepatitis B-related primary hepatocellular carcinoma

2019 ◽  
Author(s):  
Chuhui Ye ◽  
Banghao Xu ◽  
Kaiyi Lu ◽  
Tingting Lu ◽  
Ling Zhang ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Hepatitis B ◽  
Liver Failure ◽  
Liver Regeneration ◽  
Liver Volume ◽  
Primary Hepatocellular Carcinoma ◽  
Postoperative Liver Failure ◽  
Regeneration Rate ◽  
Significant Difference

Abstract Objective A retrospective analysis of the influences of platelet (PLT) counts on liver failure and liver regeneration in patients with primary hepatocellular carcinoma (HCC) provides a treatment strategy for clinical prevention and treatment of postoperative liver failure and residual liver regeneration. Method The clinical data of 111 patients with a background of hepatitis B virus infection and who underwent (expanded) half liver resection at the First Affiliated Hospital of Guangxi Medical University from June 2012 to June 2017 were collected and statistically analyzed. Results　On the basis of the International Study Group of Liver Surgery liver failure-grading standards and Dino–Clavien postoperative complication criteria, the incidence of grade B and above liver failure was 55%, and complication II level and above was 47.5% in the PLT decline group after semihepatectomy. The incidence rates in the normal group were 26.8% and 23.9%. A statistically significant difference was determined in the two groups (P1=0.003, P2 = 0.011). The average volumes of liver hyperplasia (residual liver volume (RLV)80.4 days − RLV) in the PLT decline and normal groups were 132.09 ± 61.89 cm3 and 190.89 ± 91.98c cm3, respectively; the average rates of hyperplasia ((RLV80.4days−RLV)/RLV) were 16.59%± 7.36% and 24.78% ± 10.82%. The difference between the two groups was statistically significant (PProliferation = 0.001, PProliferation rate = 0.001). Univariable and multivariable logistic regression analyses of postoperative liver failure grade and proliferation rate in patients who underwent semihepatectomy suggested that the decrease in postoperative PLT count (PLT < 125 × 109/L) might be an independent risk factor of severe posthepatectomy liver failure (PHLF) (PHLF-B or above) and residual liver regeneration rate for patients with primary HCC after half liver resection. No death occurred. Conclusions A correlation existed between PLT count and postoperative PHLF or liver regeneration. Monitoring PLT counts after liver resection may help us predict the suffering from PHLF-B or above and severe postoperative complications.

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