scholarly journals Hepatectomy Based on Future Liver Remnant Plasma Clearance Rate of Indocyanine Green

HPB Surgery ◽  
2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Yuichiro Uchida ◽  
Hiroaki Furuyama ◽  
Daiki Yasukawa ◽  
Hiroto Nishino ◽  
Yasuhisa Ando ◽  
...  
Keyword(s):  
Indocyanine Green ◽  
Clearance Rate ◽  
Plasma Clearance ◽  
Postoperative Mortality ◽  
Future Liver Remnant ◽  
International Study ◽  
Liver Malignancies ◽  
Liver Remnant ◽  
Perioperative Morbidity ◽  
Valid Criterion

Background. Hepatectomy, an important treatment modality for liver malignancies, has high perioperative morbidity and mortality rates. Safe, comprehensive criteria for selecting patients for hepatectomy are needed. Since June 2011, we have used a cut-off value of ≧ 0.05 for future liver remnant plasma clearance rate of indocyanine green as a criterion for hepatectomy. The aim of this study was to verify the validity of this criterion. Methods. From June 2011 to December 2015, 212 hepatectomies were performed in Tenri Yorozu Hospital. Of these 212 patients, 107 who underwent preoperative computed tomography imaging volumetry, indocyanine green clearance test, and hepatectomy (excluding partial resection or enucleation) were retrospectively analyzed. Results. There was no postoperative mortality. Posthepatectomy liver failure occurred in 59 patients (55.1%) (International Study Group of Liver Surgery Grade A: 43 cases (40.2%), Grade B: 16 cases (15.0%), and Grade C: no cases). Operative morbidity greater than Clavien-Dindo Grade 3 occurred in 23 patients (21.5%). A low future liver remnant plasma clearance rate of indocyanine green was a good predictor for Grade B cases (area under curve = 0.804; 95% confidence interval, 0.712–0.895). Conclusion. Liver remnant plasma clearance rate of indocyanine green is a valid criterion for hepatectomy.

scholarly journals Expanded Makuuchi's criteria using estimated indocyanine green clearance rate of future liver remnant as a safety limit for maximum extent of liver resection

HPB ◽  
2019 ◽  
Vol 21 (8) ◽  
pp. 990-997 ◽  
Author(s):  
Yuta Kobayashi ◽  
Yoshitaka Kiya ◽  
Toshitaka Sugawara ◽  
Yujiro Nishioka ◽  
Masaji Hashimoto ◽  
...  
Keyword(s):  
Liver Resection ◽  
Indocyanine Green ◽  
Clearance Rate ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Indocyanine Green Clearance ◽  
Maximum Extent ◽  
Safety Limit

scholarly journals Simultaneous ipsilateral PVE and DSM-TACE as a possible new gold standard strategy for preoperative augmentation of future liver remnant in patients with solid liver malignancies

HPB ◽  
2019 ◽  
Vol 21 ◽  
pp. S301
Author(s):  
Oleksandr Korshak ◽  
Vadim Kondratuik ◽  
Nellya Ablayeva ◽  
Andriy Zhylenko ◽  
Oleksandr Hrynenko ◽  
...  
Keyword(s):  
Gold Standard ◽  
Future Liver Remnant ◽  
Liver Malignancies ◽  
Liver Remnant ◽  
Standard Strategy

Early Graft Dysfunction Evaluation by Indocyanine Green Plasma Clearance Rate in the Immediate Postoperative Period After Liver Transplantation

2020 ◽  
Vol 52 (5) ◽  
pp. 1336-1339
Author(s):  
Esteban Horacio Gonzalez ◽  
Lucas Souto Nacif ◽  
Alex Jones Flores Cassenote ◽  
Rafael Soares Pinheiro ◽  
Vinicius Rocha-Santos ◽  
...  
Keyword(s):  
Liver Transplantation ◽  
Indocyanine Green ◽  
Postoperative Period ◽  
Clearance Rate ◽  
Plasma Clearance ◽  
Graft Dysfunction ◽  
Early Graft ◽  
Early Graft Dysfunction

scholarly journals Portal Vein Embolization is Associated with Reduced Liver Failure and Mortality in High-Risk Resections for Perihilar Cholangiocarcinoma

2020 ◽  
Vol 27 (7) ◽  
pp. 2311-2318 ◽  
Author(s):  
Pim B. Olthof ◽  
◽  
Luca Aldrighetti ◽  
Ruslan Alikhanov ◽  
Matteo Cescon ◽  
...  
Keyword(s):  
Liver Resection ◽  
Portal Vein ◽  
Liver Failure ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
International Study ◽  
Perihilar Cholangiocarcinoma ◽  
Major Liver Resection ◽  
Biliary Leakage ◽  
Liver Remnant

Abstract Background Preoperative portal vein embolization (PVE) is frequently used to improve future liver remnant volume (FLRV) and to reduce the risk of liver failure after major liver resection. Objective This paper aimed to assess postoperative outcomes after PVE and resection for suspected perihilar cholangiocarcinoma (PHC) in an international, multicentric cohort. Methods Patients undergoing resection for suspected PHC across 20 centers worldwide, from the year 2000, were included. Liver failure, biliary leakage, and hemorrhage were classified according to the respective International Study Group of Liver Surgery criteria. Using propensity scoring, two equal cohorts were generated using matching parameters, i.e. age, sex, American Society of Anesthesiologists classification, jaundice, type of biliary drainage, baseline FLRV, resection type, and portal vein resection. Results A total of 1667 patients were treated for suspected PHC during the study period. In 298 patients who underwent preoperative PVE, the overall incidence of liver failure and 90-day mortality was 27% and 18%, respectively, as opposed to 14% and 12%, respectively, in patients without PVE (p < 0.001 and p = 0.005). After propensity score matching, 98 patients were enrolled in each cohort, resulting in similar baseline and operative characteristics. Liver failure was lower in the PVE group (8% vs. 36%, p < 0.001), as was biliary leakage (10% vs. 35%, p < 0.01), intra-abdominal abscesses (19% vs. 34%, p = 0.01), and 90-day mortality (7% vs. 18%, p = 0.03). Conclusion PVE before major liver resection for PHC is associated with a lower incidence of liver failure, biliary leakage, abscess formation, and mortality. These results demonstrate the importance of PVE as an integral component in the surgical treatment of PHC.

scholarly journals Hepatocellular uptake index obtained with gadoxetate disodium-enhanced magnetic resonance imaging in the assessment future liver remnant function after major hepatectomy for biliary malignancy

BJS Open ◽  
2021 ◽  
Vol 5 (4) ◽  
Author(s):  
T Notake ◽  
A Shimizu ◽  
K Kubota ◽  
T Ikehara ◽  
H Hayashi ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Major Hepatectomy ◽  
Multivariable Analysis ◽  
Area Under The Curve ◽  
Future Liver Remnant ◽  
International Study ◽  
Gadoxetate Disodium ◽  
Liver Remnant ◽  
Biliary Malignancy

Abstract Background Functional assessment of the future liver remnant (FLR) after major hepatectomy is essential but often difficult in patients with biliary malignancy, owing to obstructive jaundice and portal vein embolization. This study evaluated whether a novel index using gadoxetate disodium-enhanced MRI (EOB-MRI) could predict posthepatectomy liver failure (PHLF) after major hepatectomy for biliary malignancy. Methods The remnant hepatocellular uptake index (rHUI) was calculated in patients undergoing EOB-MRI before major hepatectomy for biliary malignancy. Receiver operating characteristic (ROC) curve analyses were used to evaluate the accuracy of rHUI for predicting PHLF grade B or C, according to International Study Group of Liver Surgery criteria. Multivariable logistic regression analyses comprised stepwise selection of parameters, including rHUI and other conventional indices. Results This study included 67 patients. The rHUI accurately predicted PHLF (area under the curve (AUC) 0.896). A cut-off value for rHUI of less than 0.410 predicted all patients who developed grade B or C PHLF. In multivariable analysis, only rHUI was an independent risk factor for grade B or C PHLF (odds ratio 2.0 × 103, 95 per cent c.i. 19.6 to 3.8 × 107; P &lt; 0.001). In patients who underwent preoperative portal vein embolization, rHUI accurately predicted PHLF (AUC 0.885), whereas other conventional indices, such as the plasma disappearance rate of indocyanine green of the FLR and FLR volume, did not. Conclusion The rHUI is potentially a useful predictor of PHLF after major hepatectomy for biliary malignancy.

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