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The Predictive Value of Indocyanine Green Clearance in Future Liver Remnant for Posthepatectomy Liver Failure Following Hepatectomy with Extrahepatic Bile Duct Resection

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Abstract

Background

Postoperative liver failure (PHLF) is one of the most common complications following major hepatectomy. The preoperative assessment of future liver remnant (FLR) function is critical to predict the incidence of PHLF.

Objective

To determine the efficacy of the plasma clearance rate of indocyanine green clearance of FLR (ICGK-F) in predicting PHLF in cases of highly invasive hepatectomy with extrahepatic bile duct resection.

Methods

Five hundred and eighty-five patients who underwent major hepatectomy with extrahepatic bile duct resection, from 2002 to 2014 in a single institution, were evaluated. Among them, 192 patients (33 %) had PHLF. The predictive value of ICGK-F for PHLF was determined and compared with other risk factors for PHLF.

Results

The incidence of PHLF was inversely proportional to the level of ICGK-F. With multivariate logistic regression analysis, ICGK-F, combined pancreatoduodenectomy, the operation time, and blood loss were identified as independent risk factors of PHLF. The risk of PHLF increased according to the decrement of ICGK-F (the odds ratio of ICGK-F for each decrement of 0.01 was 1.22; 95 % confidence interval 1.12–1.33; P < 0.001). Low ICGK-F was also identified as an independent risk factor predicting the postoperative mortality.

Conclusions

ICGK-F is useful in predicting the PHLF and mortality in patients undergoing major hepatectomy with extrahepatic bile duct resection. This criterion may be useful for highly invasive hepatectomy, such as that with extrahepatic bile duct resection.

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References

  1. Natsume S, Ebata T, Yokoyama Y et al (2012) Clinical significance of left trisectionectomy for perihilar cholangiocarcinoma: an appraisal and comparison with left hepatectomy. Ann Surg 255:754–762

    Article  PubMed  Google Scholar 

  2. Nagino M, Kamiya J, Arai T et al (2006) “Anatomic” right hepatic trisectionectomy (extended right hepatectomy) with caudate lobectomy for hilar cholangiocarcinoma. Ann Surg 243:28–32

    Article  PubMed  PubMed Central  Google Scholar 

  3. Ebata T, Kosuge T, Hirano S et al (2014) Proposal to modify the international union against cancer staging system for perihilar cholangiocarcinomas. Br J Surg 101:79–88

    Article  CAS  PubMed  Google Scholar 

  4. Nagino M, Kamiya J, Nishio H et al (2006) Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Ann Surg 243:364–372

    Article  PubMed  PubMed Central  Google Scholar 

  5. Yokoyama Y, Nishio H, Ebata T et al (2010) Value of indocyanine green clearance of the future liver remnant in predicting outcome after resection for biliary cancer. Br J Surg 97:1260–1268

    Article  CAS  PubMed  Google Scholar 

  6. Igami T, Nishio H, Ebata T et al (2010) Surgical treatment of hilar cholangiocarcinoma in the “new era”: the Nagoya University experience. J Hepatobiliary Pancreat Sci 17:449–454

    Article  PubMed  Google Scholar 

  7. Uesaka K, Nimura Y, Nagino M (1996) Changes in hepatic lobar function after right portal vein embolization. An appraisal by biliary indocyanine green excretion. Ann Surg 223:77–83

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  8. Ebata T, Yokoyama Y, Igami T et al (2012) Portal vein embolization before extended hepatectomy for biliary cancer: current technique and review of 494 consecutive embolizations. Dig Surg 29:23–29

    Article  PubMed  Google Scholar 

  9. Nagino M, Nimura Y, Kamiya J et al (1995) Right or left trisegment portal vein embolization before hepatic trisegmentectomy for hilar bile duct carcinoma. Surgery 117:677–681

    Article  CAS  PubMed  Google Scholar 

  10. Nagino M, Nimura Y, Kamiya J et al (1996) Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach. Radiology 200:559–563

    Article  CAS  PubMed  Google Scholar 

  11. Rahbari NN, Garden OJ, Padbury R et al (2011) Posthepatectomy liver failure: a definition and grading by the International Study Group of Liver Surgery (ISGLS). Surgery 149:713–724

    Article  PubMed  Google Scholar 

  12. Rahbari NN, Reissfelder C, Koch M et al (2011) The predictive value of postoperative clinical risk scores for outcome after hepatic resection: a validation analysis in 807 patients. Ann Surg Oncol 18:3640–3649

    Article  PubMed  Google Scholar 

  13. Mangram AJ, Horan TC, Pearson ML et al (1999) Guideline for prevention of surgical site infection, 1999. Centers for Disease Control and Prevention (CDC) Hospital Infection Control Practices Advisory Committee. Am J Infect Control 27:97–132; quiz 133–134; discussion 196

  14. Kokudo N, Vera DR, Tada K et al (2002) Predictors of successful hepatic resection: prognostic usefulness of hepatic asialoglycoprotein receptor analysis. World J Surg 26:1342–1347

    Article  PubMed  Google Scholar 

  15. Nanashima A, Yamaguchi H, Shibasaki S et al (2001) Measurement of serum hyaluronic acid level during the perioperative period of liver resection for evaluation of functional liver reserve. J Gastroenterol Hepatol 16:1158–1163

    Article  CAS  PubMed  Google Scholar 

  16. Lee SG, Hwang S (2005) How I do it: assessment of hepatic functional reserve for indication of hepatic resection. J Hepatobiliary Pancreat Surg 12:38–43

    Article  PubMed  Google Scholar 

  17. Imamura H, Shimada R, Kubota M et al (1999) Preoperative portal vein embolization: an audit of 84 patients. Hepatology 29:1099–1105

    Article  CAS  PubMed  Google Scholar 

  18. Yokoyama Y, Nagino M, Oda K et al (2008) Sex dimorphism in the outcome of preoperative right portal vein embolization. Arch Surg 143:254–259; discussion 259

  19. Yokoyama Y, Ebata T, Igami T et al (2014) The adverse effects of preoperative cholangitis on the outcome of portal vein embolization and subsequent major hepatectomies. Surgery

  20. Abdalla EK, Denys A, Chevalier P et al (2004) Total and segmental liver volume variations: implications for liver surgery. Surgery 135:404–410

    Article  PubMed  Google Scholar 

  21. Shirabe K, Shimada M, Gion T et al (1999) Postoperative liver failure after major hepatic resection for hepatocellular carcinoma in the modern era with special reference to remnant liver volume. J Am Coll Surg 188:304–309

    Article  CAS  PubMed  Google Scholar 

  22. Guglielmi A, Ruzzenente A, Conci S et al (2012) How much remnant is enough in liver resection? Dig Surg 29:6–17

    Article  PubMed  Google Scholar 

  23. Nonami T, Nakao A, Kurokawa T et al (1999) Blood loss and ICG clearance as best prognostic markers of post-hepatectomy liver failure. Hepatogastroenterology 46:1669–1672

    CAS  PubMed  Google Scholar 

  24. Hemming AW, Scudamore CH, Shackleton CR et al (1992) Indocyanine green clearance as a predictor of successful hepatic resection in cirrhotic patients. Am J Surg 163:515–518

    Article  CAS  PubMed  Google Scholar 

  25. Kasai Y, Hatano E, Iguchi K et al (2013) Prediction of the remnant liver hypertrophy ratio after preoperative portal vein embolization. Eur Surg Res 51:129–137

    Article  CAS  PubMed  Google Scholar 

  26. Ohkura Y, Mizuno S, Kishiwada M et al (2014) Benefit of technetium-99 m galactosyl human serum albumin scintigraphy instead of indocyanine green test in patients scheduled for hepatectomy. Hepatol Res 44:E118–128

    Article  CAS  PubMed  Google Scholar 

  27. Hwang S, Ha TY, Song GW et al (2015) Quantified risk assessment for major hepatectomy via the indocyanine green clearance rate and liver volumetry combined with standard liver volume. J Gastrointest Surg 19:1305–1314

    Article  PubMed  Google Scholar 

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Authors and Affiliations

  1. Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Showa-ku, Nagoya, 466-8550, Japan

    Yukihiro Yokoyama, Tomoki Ebata, Tsuyoshi Igami, Gen Sugawara, Takashi Mizuno, Junpei Yamaguchi & Masato Nagino

Authors
  1. Yukihiro Yokoyama
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  2. Tomoki Ebata
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  3. Tsuyoshi Igami
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  4. Gen Sugawara
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  5. Takashi Mizuno
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  6. Junpei Yamaguchi
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  7. Masato Nagino
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Corresponding authors

Correspondence to Yukihiro Yokoyama or Masato Nagino.

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Yokoyama, Y., Ebata, T., Igami, T. et al. The Predictive Value of Indocyanine Green Clearance in Future Liver Remnant for Posthepatectomy Liver Failure Following Hepatectomy with Extrahepatic Bile Duct Resection. World J Surg 40, 1440–1447 (2016). https://doi.org/10.1007/s00268-016-3441-1

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  • DOI: https://doi.org/10.1007/s00268-016-3441-1

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