Abstract
Background/Purpose
Following a major hepatectomy, some degree of clinical and biochemical dysfunction occurs. Surgeons usually check serum total bilirubin levels to diagnose postoperative liver dysfunction. However, we cannot predict liver failure by biochemical data alone within the early postoperative period. Using newly developed pulse dye-densitometry (PDD), we measured serial postoperative indocyanine green elimination rate (ICG-K) values and investigated the possible relation between postoperative ICG-K values and complications.
Methods
Fifty-one patients scheduled for hepatectomy between January 2000 and December 2002 were enrolled. Pulse-dye densitometry was used to evaluate postoperative liver function. We analyzed the relation between postoperative ICG-K and postoperative outcome, assessed in terms of morbidity and mortality.
Results
Liver failure was seen in seven patients. The ICG-K value on postoperative day 1 in patients with liver failure was significantly lower than that in patients without liver failure (0.070 ± 0.018 vs 0.152 ± 0.056/min respectively; P < 0.001). There were no differences between preoperative ICG-K values in patients with and without liver failure. The sensitivity and specificity of an ICG-K value of less than 0.07 on postoperative day 1 were 71.4% and 95.5%, respectively, for predicting liver failure.
Conclusions
We can measure the ICG-K value by PDD at the bedside without time delay, and we can predict liver failure in the early postoperative period by the ICG-K values on postoperative day 1. ICG-K values measured by PDD can provide important information for perioperative management.
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References
M Makuuchi H Hasegawa S Yamazaki (1985) ArticleTitleUltrasonically guided subsegmentectomy Surg Gynecol Obstet 161 346–50 Occurrence Handle2996162 Occurrence Handle1:STN:280:BimD3MbktVI%3D
S Al-Hadeedi TK Choi J Wong (1990) ArticleTitleExtended hepatectomy for hepatocellular carcinoma Br J Surg 77 1247–50 Occurrence Handle2174707 Occurrence Handle1:STN:280:By6D2s%2FitVY%3D
S Miyagawa M Makuuchi S Kawasaki T Kakazu (1995) ArticleTitleCriteria for safe hepatic resection Am J Surg 169 589–94 Occurrence Handle7771622 Occurrence Handle1:STN:280:ByqB1cblsFE%3D Occurrence Handle10.1016/S0002-9610(99)80227-X
J Belghiti S Ogata (2005) ArticleTitleAssessment of hepatic reserve for indication of hepatic resection J Hepatobiliary Pancreat Surg 12 1–3 Occurrence Handle15754091 Occurrence Handle10.1007/s00534-004-0951-2
C Child J Turcotte (1964) Surgery and portal hypertension C Child (Eds) The liver and portal hypertension WB Saunders Philadelphia 50–1
RN Pugh IM Murray-Lyon JL Dawson MC Pieroni R Williams (1973) ArticleTitleTransection of the esophagus for bleeding esophageal varices Br J Surg 60 646–9 Occurrence Handle4541913 Occurrence Handle1:STN:280:CSyB3svhvFU%3D
T Nonami A Nakao T Kurokawa H Inagaki Y Matsushita J Sakamoto et al. (1999) ArticleTitleBlood loss and ICG clearance as best prognostic marker of post-hepatectomy liver failure Hepatogastroenterology 46 1669–72 Occurrence Handle10430318 Occurrence Handle1:STN:280:DyaK1MzlslertQ%3D%3D
H Lau K Man ST Fan WC Yu CM Lo J Wong (1997) ArticleTitleEvaluation of preoperative heptic function in patients with hepatocellular carcinoma undergoing hepatectomy Br J Surg 84 1255–9 Occurrence Handle9313707 Occurrence Handle1:STN:280:ByiH2MfptlY%3D Occurrence Handle10.1002/bjs.1800840917
Y Midorikawa K Kubota T Takayama H Toyoda M Ijichi G Torzilli et al. (1999) ArticleTitleA comparative study of postoperative complications after hepatectomy in patients with and without chronic liver disease Surgery 126 484–91 Occurrence Handle10486600 Occurrence Handle1:STN:280:DyaK1Mvhs1Smtg%3D%3D
H Imamura K Sano Y Sugawara N Kokudo M Makuuchi (2005) ArticleTitleAssessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test J Hepatobiliary Pancreat Surg 12 16–22 Occurrence Handle15754094 Occurrence Handle10.1007/s00534-004-0965-9
T Iijima T Aoyagi Y Iwao J Masuda M Fuse N Kobayashi et al. (1997) ArticleTitleCardiac output and circulating blood volume analysis by pulse dye-densitometry J Clin Monit 13 81–9 Occurrence Handle9112203 Occurrence Handle1:STN:280:ByiB28nkt1Q%3D Occurrence Handle10.1023/A:1007339924083
T Imai K Takahashi H Fukura Y Morishita (1997) ArticleTitleMeasurement of cardiac output by pulse dye-densitometry using indocyanine green Anesthesiology 87 816–22 Occurrence Handle9357883 Occurrence Handle1:STN:280:DyaK1c%2FhvV2itw%3D%3D Occurrence Handle10.1097/00000542-199710000-00015
T Iijima Y Iwao S Sankawa (1998) ArticleTitleCirculating blood volume measured by pulse dye-densitometry: comparison with 131I-HAS analysis Anesthesiology 89 1329–35 Occurrence Handle9856706 Occurrence Handle1:CAS:528:DyaK1MXhtl2hsg%3D%3D Occurrence Handle10.1097/00000542-199812000-00009
O Okochi T Kaneko H Sugimoto S Inoue S Takeda A Nakao (2002) ArticleTitleICG pulse spectrophotometry for perioperative liver function in hepatectomy J Surg Res 103 109–13 Occurrence Handle11855925 Occurrence Handle10.1006/jsre.2001.6328
Y Fujii H Shimada I Endo D Morioka Y Kagano Y Miura et al. (2003) ArticleTitleRisk factor of posthepatectomy liver failure after portal vein embolization J Hepatobiliary Pancreat Surg 10 226–32 Occurrence Handle14605980 Occurrence Handle10.1007/s00534-002-0820-9
I Nagashima T Takada K Okinaga H Nagawa (2005) ArticleTitleA scoring system for the assessment of risk of mortality after partial hepatectomy in patients with chronic liver dysfunction J Hepatobiliary Pancreat Surg 12 44–8 Occurrence Handle15754099 Occurrence Handle10.1007/s00534-004-0953-0
H Sugimoto T Kaneko S Inoue S Takeda A Nakao (2002) ArticleTitleSimultaneous Doppler measurement of portal venous peak velocity, hepatic arterial peak velocity, and splenic arterial pulsatility index for assessment of hepatic circulation Hepatogastroenterology 46 793–7
H Sugimoto T Kaneko S Takeda S Inoue A Nakao (2002) ArticleTitleThe use of quantitative Doppler ultrasonography to predict posthepatectomy complications on the basis of hepatic hemodynamic parameters Surgery 132 431–40 Occurrence Handle12324756 Occurrence Handle10.1067/msy.2002.126407
S Yachida H Wakabayashi Y Kokudo F Goda S Okada T Maeba et al. (2000) ArticleTitleMeasurement of serum hyaluronate as a predictor of human liver failure after major hepatectomy World J Surg 24 359–64 Occurrence Handle10658073 Occurrence Handle1:STN:280:DC%2BD3c7is1Cgtw%3D%3D Occurrence Handle10.1007/s002689910057
S Kubo T Tsukamoto K Hirohashi H Tanaka T Shuto S Takemura et al. (2004) ArticleTitleCorrelation between preoperative serum concentration of type IV collagen 7s domain and hepatic failure following resection of hepatocellular carcinoma Ann Surg 239 186–93 Occurrence Handle14745326 Occurrence Handle10.1097/01.sla.0000109152.48425.4d
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Sugimoto, H., Okochi, O., Hirota, M. et al. Early detection of liver failure after hepatectomy by indocyanine green elimination rate measured by pulse dye-densitometry. J Hepatobiliary Pancreat Surg 13, 543–548 (2006). https://doi.org/10.1007/s00534-006-1114-4
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DOI: https://doi.org/10.1007/s00534-006-1114-4