Browse > Article

Major Hepatectomy in the HCC Patient with an Indocyanine Green Retention Rate at 15 Minutes of 10% or Higher: Predictive Values of Postoperative Hepatic Failure  

Lee, Chae Yoon (Department of Surgery, Kyungpook National University Hospital)
Hwang, Yoon Jin (Department of Surgery, Kyungpook National University Hospital)
Chun, Jae Min (Department of Surgery, Kyungpook National University Hospital)
Kwon, Hyung Joon (Department of Surgery, Kyungpook National University Hospital)
Son, Joon Ho (Department of Surgery, Kyungpook National University Hospital)
Kim, Sang Gul (Department of Surgery, Kyungpook National University Hospital)
Yun, Yung Kook (Department of Surgery, Kyungpook National University Hospital)
Publication Information
Annals of Hepato-Biliary-Pancreatic Surgery / v.15, no.1, 2011 , pp. 1-6 More about this Journal
Abstract
Purpose: Major hepatic resection is sometimes inevitable in patients with impaired liver function. We evaluated risk factors that cause postoperative liver failure after major hepatic resection in patients with over a 10% Indocyanine Green Retention rate at 15 minutes (ICGR15). Methods: From Apr. 2002 to Aug. 2009, 32 patients who had over a 10% rate of ICGR15 underwent major hepatic resection (${\geq}$4 Couinaud segments). Among the 32, 9 patients showed postoperative liver failure (less than 50% prothrombine time and/or 5 mg/dl or higher of total bilirubin). This high-risk group was compared to the rest who constituted a low-risk group. Results: Patients with esophageal varix were more common in the high risk group (4 versus 2, p=0.043). Other clinicopathologic features showed no difference between the two groups. We had 2 in-hospital deaths in the high risk group. Conclusion: Great care is needed in patients with esophageal varix and limited liver function during major hepatic resection.
Keywords
Hepatocellular carcinoma; Hepatectomy; Hepatic failure; Esophageal varix;
Citations & Related Records
Times Cited By KSCI : 2  (Citation Analysis)
연도 인용수 순위
1 Park JW; Korean Liver Cancer Study Group and National Cancer Center. Practice guideline for diagnosis and treatment of hepatocellular carcinoma. Korean J Hepatol 2004;10:88-98.
2 Bruix J, Sherman M; Practice Guidelines Committee, American Association for the Study of Liver Diseases. Management of hepatocellular carcinoma. Hepatology 2005;42:1208-1236.   DOI   ScienceOn
3 Poon RT, Fan ST, Lo CM, et al. Improving survival results after resection of hepatocellular carcinoma: a prospective study of 377 patients over 10 years. Ann Surg 2001;234:63-70.   DOI   ScienceOn
4 Cha CH, Ruo L, Fong Y, et al. Resection of hepatocellular carcinoma in patients otherwise eligible for transplantation. Ann Surg 2003;238:315-321.
5 Belghiti J, Cortes A, Abdalla EK, et al. Resection prior to liver transplantation for hepatocellular carcinoma. Ann Surg 2003; 238:885-892.   DOI   ScienceOn
6 Margarit C, Escartin A, Castells L, Vargas V, Allende E, Bilbao I. Resection for hepatocellular carcinoma is a good option in Child-Turcotte-Pugh class A patients with cirrhosis who are eligible for liver transplantation. Liver Transpl 2005;11: 1242-1251.   DOI   ScienceOn
7 Majno P, Mentha G, Mazzaferro V. Resection, transplantation, either, or both? Other pieces of the puzzle. Liver Transpl 2005;11:1177-1180.   DOI   ScienceOn
8 Caesar J, Shaldon S, Chiandussi L, Guevar L, Sherlock S. The use of indocyanine green in the measurement of hepatic blood flow and as a test of hepatic function. Clin Sci 1961;21:43-57.
9 Takasaki K. Development of a method of estimating postoperative hepatic functions upon hepatectomy before the operation. J Jpn Surg Soc 1978;79:1526-1534.
10 Takasaki T, Kobayashi S, Suzuki S, et al. Predetermining postoperative hepatic function for hepatectomies. Int Surg 1980;65:309-313.
11 Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery 1984;95:586-592.
12 Yamanaka N, Okamoto E, Kuwata K, Tanaka N. A multiple regression equation for prediction of posthepatectomy liver failure. Ann Surg 1984;200:658-663.   DOI   ScienceOn
13 Makuuchi M, Hasegawa H, Yamazaki S. Indication for hepatectomy in patients with hepatocellular carcinoma and cirrhosis (In Japanese). Shindan to Chiryo 1986;74:1225-1230.
14 Lam CM, Fan ST, Lo CM, Wong J. Major hepatectomy for hepatocellular carcinoma in patients with an unsatisfactory indocyanine green clearance test. Br J Surg 1999;86: 1012-1017.   DOI   ScienceOn
15 Lang BH, Poon RT, Fan ST, Wong J. Perioperative and long-term outcome of major hepatic resection for small solitary hepatocellular carcinoma in patients with cirrhosis. Arch Surg 2003;138:1207-1213.   DOI   ScienceOn
16 Child CG III, Turcotte JG. Surgery and portal hypertension. In: Child CG III, editor. The Liver and Portal Hypertension. Philadelphia: Saunders; 1964. 49-50.
17 Pugh RN, Murray-Lyon IM, Dawson JL, Pietroni MC, Williams R. Transection of the oesophagus for bleeding oesophageal varices. Br J Surg 1973;60:646-649.   DOI   ScienceOn
18 Bruix J, Castells A, Bosch J, et al. Surgical resection of hepatocellular carcinoma in cirrhotic patients: prognostic value of preoperative portal pressure. Gastroenterology 1996;111:1018-1022.   DOI   ScienceOn
19 An M, Park JW, Shin JA, et al. The adverse effect of indirectly diagnosed portal hypertension on the complications and prognosis after hepatic resection of hepatocellular carcinoma. Korean J Hepatol 2006;12:553-561.
20 Llovet JM, Fuster J, Bruix J. Intention-to-treat analysis of surgical treatment for early hepatocellular carcinoma: resection versus transplantation. Hepatology 1999;30:1434- 1440.   DOI
21 Yamanaka N, Okamoto E, Toyosaka A, et al. Prognostic factors after hepatectomy for hepatocellular carcinomas. A univariate and multivariate analysis. Cancer 1990;65:1104- 1110.   DOI   ScienceOn
22 Fan ST, Lai EC, Lo CM, Ng IO, Wong J. Hospital mortality of major hepatectomy for hepatocellular carcinoma associated with cirrhosis. Arch Surg 1995;130:198-203.   DOI   ScienceOn
23 Lau H, Man K, Fan ST, Yu WC, Lo CM, Wong J. Evaluation of preoperative hepatic function in patients with hepatocellular carcinoma undergoing hepatectomy. Br J Surg 1997;84:1255-1259.   DOI   ScienceOn
24 Imamura H, Seyama Y, Kokudo N, et al. One thousand fifty-six hepatectomies without mortality in 8 years. Arch Surg 2003;138:1198-1206.   DOI   ScienceOn
25 Okamoto E, Kyo A, Yamanaka N, Tanaka N, Kuwata K. Prediction of the safe limits of hepatectomy by combined volumetric and functional measurements in patients with impaired hepatic function. Surgery 1984;95:586-592.
26 Makuuchi M, Kosuge T, Takayama T, et al. Surgery for small liver cancers. Semin Surg Oncol 1993;9:298-304.   DOI   ScienceOn
27 Kubota K, Makuuchi M, Kusaka K, et al. Measurement of liver volume and hepatic functional reserve as a guide to decision-making in resectional surgery for hepatic tumors. Hepatology 1997;26:1176-1181.