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

2016 ◽  
Vol 40 (6) ◽  
pp. 1440-1447 ◽  
Author(s):  
Yukihiro Yokoyama ◽  
Tomoki Ebata ◽  
Tsuyoshi Igami ◽  
Gen Sugawara ◽  
Takashi Mizuno ◽  
...  
Keyword(s):  
Bile Duct ◽  
Liver Failure ◽  
Indocyanine Green ◽  
Extrahepatic Bile Duct ◽  
Future Liver Remnant ◽  
Bile Duct Resection ◽  
Liver Remnant ◽  
Indocyanine Green Clearance ◽  
Posthepatectomy Liver Failure ◽  
Extrahepatic Bile Duct Resection

scholarly journals Utility of remnant liver volume for predicting posthepatectomy liver failure after hepatectomy with extrahepatic bile duct resection

BJS Open ◽  
2021 ◽  
Vol 5 (1) ◽  
Author(s):  
R Yamamoto ◽  
T Sugiura ◽  
Y Okamura ◽  
T Ito ◽  
Y Yamamoto ◽  
...  
Keyword(s):  
Risk Factors ◽  
Bile Duct ◽  
Liver Failure ◽  
Extrahepatic Bile Duct ◽  
Liver Volume ◽  
Remnant Liver ◽  
Bile Duct Resection ◽  
Posthepatectomy Liver Failure ◽  
Remnant Liver Volume ◽  
Extrahepatic Bile Duct Resection

Abstract Background Hepatectomy with extrahepatic bile duct resection is associated with a high risk of posthepatectomy liver failure (PHLF). However, the utility of the remnant liver volume (RLV) in cholangiocarcinoma has not been studied intensively. Methods Patients who underwent major hepatectomy with extrahepatic bile duct resection between 2002 and 2018 were reviewed. The RLV was divided by body surface area (BSA) to normalize individual physical differences. Risk factors for clinically relevant PHLF were evaluated with special reference to the RLV/BSA. Results A total of 289 patients were included. The optimal cut-off value for RLV/BSA was determined to be 300 ml/m2. Thirty-two patients (11.1 per cent) developed PHLF. PHLF was more frequent in patients with an RLV/BSA below 300 ml/m2 than in those with a value of 300 ml/m2 or greater: 19 of 87 (22 per cent) versus 13 of 202 (6.4 per cent) (P < 0.001). In multivariable analysis, RLV/BSA below 300 ml/m2 (P = 0.013), future liver remnant plasma clearance rate of indocyanine green less than 0.075 (P = 0.031), and serum albumin level below 3.5 g/dl (P = 0.015) were identified as independent risk factors for PHLF. Based on these risk factors, patients were classified into three subgroups with low (no factors), moderate (1–2 factors), and high (3 factors) risk of PHLF, with PHLF rates of 1.8, 14.8 and 63 per cent respectively (P < 0.001). Conclusion An RLV/BSA of 300 ml/m2 is a simple predictor of PHLF in patients undergoing hepatectomy with extrahepatic bile duct resection.

Postoperative Liver Failure Criteria for Predicting Mortality after Major Hepatectomy with Extrahepatic Bile Duct Resection

2018 ◽  
Vol 36 (2) ◽  
pp. 158-165 ◽  
Author(s):  
Takeshi Kawamura ◽  
Takehiro Noji ◽  
Keisuke Okamura ◽  
Kimitaka Tanaka ◽  
Yoshitsugu Nakanishi ◽  
...  
Keyword(s):  
Bile Duct ◽  
Liver Failure ◽  
Total Bilirubin ◽  
Major Hepatectomy ◽  
Extrahepatic Bile Duct ◽  
Study Cohort ◽  
Bile Duct Resection ◽  
Predictive Values ◽  
Extrahepatic Bile Duct Resection ◽  
Related Mortality

Background: Post-hepatectomy liver failure (PHLF) is a serious complication after major hepatectomy with extrahepatic bile duct resection (Hx with EBDR) that may cause severe morbidity and even death. The purpose of this study was to compare several criteria systems as predictors of PHLF-related mortality following Hx with EBDR for perihilar cholangiocarcinoma (PHCC). Methods: The study cohort consisted of 222 patients who underwent Hx with EBDR for PHCC. We compared several criteria systems, including previously established criteria (the International Study Group of Liver Surgery (ISGLS) criterion; and the “50-50” criterion), and our institution’s novel systems “Max T-Bili” defined as total bilirubin (T-Bili) >7.3 mg/dL during post-operative days (POD) 1–7, and the “3-4-50” criterion, defined as total bilirubin >4 mg/dL and prothrombin time <50% on POD #3. Results: Thirteen patients (5.8%) died from PHLF-related causes. The 3-4-50 criterion showed high positive predictive values (39.1%), the 3-4-50, Max T-Bili, and 50-50 criterion showed high accuracies (91.7, 86.9, and 90.5%, respectively) and varying sensitivities (69.2, 69.2, and 38.5% respectively). Conclusions: The 3-4-50, Max T-Bili, and 50-50 criterion were all useful for predicting PHLF-related mortality after Hx with EBDR for PHCC.

scholarly journals Major Hepatectomy in a Child with Extremely Low Future Liver Remnant Without Posthepatectomy Liver Failure

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S201
Author(s):  
D. Akhaladze ◽  
D. Kachanov ◽  
G. Rabaev ◽  
N. Merkulov ◽  
N. Uskova ◽  
...  
Keyword(s):  
Liver Failure ◽  
Major Hepatectomy ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Posthepatectomy Liver Failure

Future Liver Remnant Indocyanine Green Plasma Clearance Rate as a Predictor of Post-hepatectomy Liver Failure After Portal Vein Embolization

2018 ◽  
Vol 41 (12) ◽  
pp. 1877-1884 ◽  
Author(s):  
Mitsunari Maruyama ◽  
Takeshi Yoshizako ◽  
Hisatoshi Araki ◽  
Rika Yoshida ◽  
Shinji Ando ◽  
...  
Keyword(s):  
Portal Vein ◽  
Liver Failure ◽  
Indocyanine Green ◽  
Portal Vein Embolization ◽  
Clearance Rate ◽  
Plasma Clearance ◽  
Future Liver Remnant ◽  
Liver Remnant

Indication of extrahepatic bile duct resection for gallbladder cancer

2017 ◽  
Vol 403 (1) ◽  
pp. 45-51 ◽  
Author(s):  
Hiroshi Kurahara ◽  
Kosei Maemura ◽  
Yuko Mataki ◽  
Masahiko Sakoda ◽  
Satoshi Iino ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gallbladder Cancer ◽  
Extrahepatic Bile Duct ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection

scholarly journals A case with massive hemobilia long-term after internal drainage surgery for congenital biliary dilation

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shunryo Minezaki ◽  
Takeyuki Misawa ◽  
Makoto Watanabe ◽  
Hideki Takahashi ◽  
Takashi Koenuma ◽  
...  
Keyword(s):  
Bile Duct ◽  
Gastrointestinal Bleeding ◽  
Pathological Condition ◽  
Extrahepatic Bile Duct ◽  
Pathological Examination ◽  
Emergency Setting ◽  
Internal Drainage ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection ◽  
Life Threatening

Abstract Background Currently, there is an unwavering consensus that the standard surgery for congenital biliary dilation (CBD) is extrahepatic bile duct resection and choledochojejunostomy. However, decades prior, choledochocyst–gastrointestinal anastomosis without extrahepatic bile duct resection (internal drainage surgery, IDS) was preferred for CBD because of its simplicity. Currently, there is almost no chance of a surgeon encountering a patient who has undergone old-fashioned IDS, which has been completely obsolete due to the risk of carcinogenesis from the remaining bile duct. Moreover, the pathological condition long after IDS is unclear. Herein, we report a case of life-threatening bile duct bleeding as well as carcinoma of the bile duct 62 years after IDS in a patient with CBD. Case presentation An 82-year-old Japanese woman with hemorrhagic shock due to gastrointestinal bleeding was transferred to our hospital. She had a medical history of unspecified surgery for CBD at the age of 20. Based on imaging findings and an understanding of the historical transition of the surgical procedure for CBD, the cause of gastrointestinal bleeding was determined to be rupture of the pseudoaneurysm of the dilated bile duct that remained after IDS. Hemostasis was successfully performed by transcatheter arterial embolization (TAE) in an emergency setting. Then, elective surgery for extrahepatic bile duct resection and choledochojejunostomy was performed to prevent rebleeding. Pathological examination revealed severely and chronically inflamed mucosa of the bile duct. Additionally, cholangiocarcinoma (Tis, N0, M0, pStage 0) was incidentally revealed. Conclusion It has been indicated that not only carcinogenesis, but also a risk of life-threatening bleeding exists due to long-lasting chronic inflammation to the remnant bile duct after IDS for CBD. Additionally, both knowledge of which CBD operation was performed, and an accurate clinical history are important for the diagnosis of hemobilia.

Discrepancy between volume and functional recovery in early phase liver regeneration following extended hepatectomy with extrahepatic bile duct resection

2019 ◽  
Vol 49 (10) ◽  
pp. 1227-1235 ◽  
Author(s):  
Takashi Maeda ◽  
Yukihiro Yokoyama ◽  
Tomoki Ebata ◽  
Tsuyoshi Igami ◽  
Takashi Mizuno ◽  
...  
Keyword(s):  
Bile Duct ◽  
Liver Regeneration ◽  
Functional Recovery ◽  
Early Phase ◽  
Extrahepatic Bile Duct ◽  
Extended Hepatectomy ◽  
Bile Duct Resection ◽  
Extrahepatic Bile Duct Resection
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