Abstract
True functional reserve of remnant liver should be determined at the same condition that contemplated hepatectomy has been performed, and this condition can be achieved before resection by temporary lamping of the inflow vessels of hepatic lobes to be removed. Using indocyanine green (ICG), the remnant liver function (RLF) was evaluated whether or not the method can be a useful indicator for or against hepatomy. In the study of healthy dogs, the RLF proved to be a reliable indicator to prospect hepatic failure which may occur after extensive resection of the liver. Then, the method was employed in nine patients who underwent 40 to 70 per cent hepatectomy. The results indicated that the RLF with ICG during surgery, if performed under stable hemodynamics, is a beneficial tool to decide the resectability in equivocal cases.
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References
Almersjo, O., Bengmark, S., Hafstrom, L. O., and Olsson, R.: Enzyme and functional changes after extensive liver resection in man,Ann. Surg. 169: 111–119, 1969.
Aronsen, K. F., Ericsson, B. and Phil, B.: Metabolic changes following major hepatic resection,ann. Surg. 169: 102–110, 1969.
Balasegaram, M.: Management of primary liver cell carcinoma,Am. J. Surg. 130: 33–37, 1975.
Lin, T. Y. and Chen, C. C.: Metabolic function and regeneration of cirrhotic and non-cirrhotic livers after hepatic lobectomy in man,Ann. Surg. 162: 959–972, 1965.
Lin, T. Y.: Personal communication.
McDermott, W. V., Jr., Greenberger, N. J., Isselbacher, K. J., and Weber, A. L.: Major hepatic resection; diagnostic techniques and metabolic problems,Surgery 54: 56–66, 1963.
Monaco, A. P., Hallgrimsson, J. and McDermott, W. V., Jr.: Multiple adenoma (hamartoma) of the liver treated by subtotal (90%) resection: Morphological and functional studies of regeneration,Ann. Surg. 159: 513–519, 1964.
Nagasue, N., Inokuchi, K., Kobayashi, M., Ogawa, Y., Saku, M., Iwaki, A. and Yukaya, H.: Angiographic evaluation of hepatoma for surgical treatment,Surg. Gynecol. Obstet. 143: 184–190, 1976.
Nagasue, N., Inokuchi, K., Kobayashi, M., Ogawa, Y., Iwaki, A. and Yukaya, H.: Hepatic dearterialization for nonresectable primary and secondary tumors of the liver,Cancer 38: 2593–2603, 1976.
Ozawa, K., Yamaoka, Y., Kitamura, O., Nambu, H., Kamiyama, Y., Takeda, O., Takasan, H. and Honjo, I.: Clinical application of cytochrome a (+a3) assay of mitochondria from liver specimens: An aid in determining metabolic tolerance of liver ramnant for hepatic resection,Ann. Surg. 180: 868–876, 1974.
Pack, G. T. and Molander, D. W.: Metabolism before and after hepatic lobectomy for cancer,Arch. Surg. 80: 685–692, 1960.
Sigel, B.: Partial hepatectomy in the dog,Arch. Surg. 80: 100–103, 1963.
Starzl, T. E., Putnam, C. W., Groth, C. G., Corman, J. L. and Taubman, J.: Alopecia, ascites, and incomplete regeneration after 85 to 90 per cent liver resection,Am. J. Surg. 129: 587–590, 1975.
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Nagasue, N., Inokuchi, K., Iwaki, A. et al. Remnant liver function during surgery for extensive hepatic resection. The Japanese Journal of Surgery 9, 125–131 (1979). https://doi.org/10.1007/BF02468847
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DOI: https://doi.org/10.1007/BF02468847