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Correlation of the ICG test with risk factors and postoperative outcomes following hepatic resection.
- Source :
-
Journal of B.U.ON. : official journal of the Balkan Union of Oncology [J BUON] 2013 Jul-Sep; Vol. 18 (3), pp. 703-7. - Publication Year :
- 2013
-
Abstract
- Purpose: Liver failure is a major cause of early mortality following hepatectomy. The future-remnant liver function is an important factor when assessing the risk for postoperative liver functional impairment. Several techniques have been established for this evaluation, including the indocyanine green (ICG) test. The aim of this study was to evaluate the ICG clearance in patients scheduled for liver resection regarding perioperative and postoperative risk factors.<br />Methods: Thirty-one patients, scheduled for liver resection, underwent the ICG test. Peri-operative and postoperative variables were recorded and analyzed using non-parametric tests.<br />Results: Procedures extended from wedge excisions to extended hepatectomies. Plasma disappearance rate (PDR) was found positively correlated with total blood loss, transfusion and operation duration. There were 11 primary hepatic malignancies, including hepatocellular carcinomas and cholangiocarcinomas, 13 metastatic carcinomas, mainly of colorectal origin, and 7 benign lesions. The uninvolved liver parenchyma was normal in 20 (64. 5%) cases. Two patients died due to myocardial infarction and postoperative liver failure, respectively.<br />Conclusion: The role of residual liver function and particularly the hepatic reserve assessment on liver surgery may be of most benefit in the routine stratification of risk, enabling surgical procedures to be performed with safety. The ICG clearance markers were found significantly correlated with perioperative risk factors in histologically "normal" liver parenchyma. In addition to computed tomographic (CT) volumetry, functional assessment of the hepatic reserve with the ICG test may persuade the preoperative planning and prevent postoperative liver failure.
- Subjects :
- Adult
Aged
Aged, 80 and over
Bile Duct Neoplasms complications
Bile Duct Neoplasms pathology
Bile Duct Neoplasms surgery
Bile Ducts, Intrahepatic pathology
Bile Ducts, Intrahepatic surgery
Carcinoma, Hepatocellular complications
Carcinoma, Hepatocellular pathology
Carcinoma, Hepatocellular surgery
Cholangiocarcinoma complications
Cholangiocarcinoma pathology
Cholangiocarcinoma surgery
Coloring Agents
Female
Follow-Up Studies
Humans
Liver Failure etiology
Liver Function Tests
Liver Neoplasms pathology
Liver Neoplasms surgery
Male
Middle Aged
Neoplasm Staging
Prognosis
Risk Factors
Hepatectomy adverse effects
Indocyanine Green
Liver Failure diagnosis
Liver Neoplasms complications
Postoperative Complications
Subjects
Details
- Language :
- English
- ISSN :
- 1107-0625
- Volume :
- 18
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- Journal of B.U.ON. : official journal of the Balkan Union of Oncology
- Publication Type :
- Academic Journal
- Accession number :
- 24065486