Evaluation of Liver Reserve Function by ICGR15 Detection before Hepatectomy for Hepatocellular Carcinoma
LAO Xiang-Ming1,ZHANG Ya-Qi1,GUAN Yuan-Xiang2,GUO Rong-Ping1,LIN Xiao-Jun1,YUAN Yun-Fei1,LI Jin-Qing1,LI Guo-Hui1 1.Department of Hepatobiliary,Cancer Center,Sun Yat-sen University,Guangzhou,Guangdong,510060,P.R.China 2.Department of Abdominal Surgery,Cancer Center,Sun Yat-sen University,Guangzhou,Guangdong,510060,P.R.China
BACKGROUND OBJECTIVE: Accurate estimation of liver reserve functi on before hepatectomy for liver cancer may avoid postoperative liver failure. Re cently, it has been considered that indocyanine green retention rate at 15 minut es (ICGR15) can assess liver reserve function with exactitude and high sensitivi ty. This study was to discuss the evaluation of liver cirrhosis severity and liv er reverse function by ICGR15, analyze the relationship between ICGR15 and post-operative liver failure,and compare ICGR15 with Child-Pugh grading. METHODS: Records of 225 patients with resected hepatocellular carcinoma (HCC) have been c ollected. Pre-operative data,such as a variety of routine liver biochemistry te sts, Child-Pugh grading,and ICGR15 value, and intra-operative data,post-opera tive data were analyzed. RESULTS: The mean value of ICGR15 was (9.9±6.2)%in ci rrhosis group, and (7.4±3.8)%in non-cirrhosis group (P 0.01). The mean value of ICGR15 was (8.5±5.0)%in mild cirrhosis subgroup,(10.7±5.7)%in moderate c irrhosis subgroup, and (15.8±9.6)%in severe cirrhosis subgroup; significant di fferences can be observed while multiple comparisons were performed (P 0.05). T he mean values of ICGR15 in patients who suffered from post-operative ascites, and jaundice were (11.5±6.8)%, and (12.1±7.1)%; significantly higher than th ose without ascites, and jaundice [(8.5±4.9)%, and (9.0±5.3)%] (P 0.05). Po ssible predictor variables indicating risk factors of post-operative complicati ons were entered into a multiple logistic regression model, the results showed t hat ICGR15 significantly affected the occurrence of both post-operative ascites and jaundice (P 0.05). The mean value of ICGR15 of patients of Child-Pugh B g rade was (15.2±8.6)%, much higher than that of patients of Child-Pugh A grade [(8.8±5.1)%](P 0.01). ICGR15 values were above 10%in 67 of the 212 patients of Child-Pugh A grade, and 6 of these 67 patients have a value above 20%. CON CLUSIONS: ICGR15 value rises with the aggravation of liver cirrhosis, it affects the occurrence of post-operative liver failure significantly. Some correlation can be observed between ICGR15 and Child-Pugh grading.
【CateGory Index】： R735.7