scholarly journals Preoperative ICG Test to Predict Posthepatectomy Liver Failure and Postoperative Outcomes in Hilar Cholangiocarcinoma

2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Min Li ◽  
Jie Wang ◽  
Jieqiong Song ◽  
Feng Shen ◽  
Lujun Song ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Liver Function ◽  
Liver Failure ◽  
Clinical Significance ◽  
Hilar Cholangiocarcinoma ◽  
Retention Rate ◽  
Univariate Analysis ◽  
Postoperative Outcomes ◽  
Posthepatectomy Liver Failure ◽  
Icg R15

Preoperative evaluation of hepatic functional reserve in patients with hilar cholangiocarcinoma (hCCA) has vital clinical significance for prevention of posthepatectomy liver failure (PHLF) and mortality. The aim of the present study was to evaluate the clinical significance of the indocyanine green retention rate at 15 minutes (ICG R15) and related factors of postoperative outcomes in patients with hCCA. 147 patients who scheduled for hCCA resection underwent a preoperative ICG test between May 2015 and May 2020 and were prospectively analyzed. Single-factor analysis was used to evaluate the risk factors for PHLF and postoperative outcomes in hCCA. After univariate analysis, significant differences in ICG R15 were found between the PHLF group and the liver function recovered well (LFRW) group ( P ≤ 0.05 ). In terms of postoperative complications, ICG R15 was also a risk factor for moderate-to-severe postoperative complications. Preoperative ICG R15 was significantly associated with PHLF and moderate-to-severe postoperative complications. ICG R15 may become an ideal clinical indicator for the evaluation of liver function reserve before hCCA and can better predict the postoperative complications.

scholarly journals Portal Vein Pressure Change Predicts Posthepatectomy Liver Failure Following Right Lobectomy

2016 ◽  
Vol 101 (9-10) ◽  
pp. 437-442 ◽  
Author(s):  
Hiroya Iida ◽  
Tsukasa Aihara ◽  
Shinichi Ikuta ◽  
Naoki Yamanaka
Keyword(s):  
Liver Failure ◽  
Retention Rate ◽  
Venous Pressure ◽  
Univariate Analysis ◽  
Activity Level ◽  
Hospital Death ◽  
Hepatic Functional Reserve ◽  
Functional Reserve ◽  
Intraoperative Bleeding ◽  
Posthepatectomy Liver Failure

The aim of this study was to evaluate the usefulness of intraoperative portal venous pressure (PVP) as a predictor of posthepatectomy liver failure (PHLF). Hepatic functional reserve is typically evaluated by using parameters such as albumin level, platelet count, prothrombin activity level, or indocyanine green retention rate at 15 minutes. Low hepatic functional reserve can enhance the risk of PHLF. We retrospectively analyzed the outcomes of 35 patients who underwent right lobectomy and intraoperative PVP measurements between April 2004 and August 2012. According to preoperative prediction scores, all patients were within a safe limit for right lobectomy. The patients were grouped into uncomplicated (n = 22) and PHLF (n = 13) groups by postoperative course. PHLF was defined as grade B or C according to International Study Group of Liver Surgery criteria. Patient background, intraoperative bleeding, operative time, and PVP elevation after hepatectomy (ΔPVP) grade were compared between the groups. No cases of in-hospital death occurred. Univariate analysis revealed significant differences in preoperative white blood counts, intraoperative bleeding, and ΔPVP between the groups (P < 0.05). The ΔPVP was an independent risk factor on multivariate analysis. A ΔPVP >3 cmH2O was associated with PHLF at 69.2% sensitivity and 90.9% specificity. Following right lobectomy, a ΔPVP >3 cmH2O indicates a risk of PHLF and warrants careful postoperative management.

scholarly journals Predictive value of gadoxetic acid–enhanced MRI for posthepatectomy liver failure: a systematic review

2021 ◽  
Author(s):  
Qiang Wang ◽  
Anrong Wang ◽  
Ernesto Sparrelid ◽  
Jiaxing Zhang ◽  
Ying Zhao ◽  
...  
Keyword(s):  
Systematic Review ◽  
Liver Function ◽  
Liver Failure ◽  
Risk Of Bias ◽  
Gadoxetic Acid ◽  
Imaging Biomarker ◽  
Cochrane Library ◽  
Large Sample Size ◽  
Posthepatectomy Liver Failure ◽  
Enhanced Mri

Abstract   Objectives Effective and non-invasive biomarkers to predict and avoid posthepatectomy liver failure (PHLF) are urgently needed. This systematic review aims to evaluate the efficacy of gadoxetic acid–enhanced MRI-derived parameters as an imaging biomarker in preoperative prediction of PHLF. Methods A systematic literature search was performed in the databases of PubMed/Medline, Web of Science, Embase, and Cochrane Library up to 11 December 2020. Studies evaluating the incidence of PHLF on patients who underwent hepatectomy with preoperative liver function assessment using gadoxetic acid–enhanced MRI were included. Data was extracted using pre-designed tables. The Quality In Prognostic Studies (QUIPS) tool was adopted to evaluate the risk of bias. Results A total of 15 studies were identified for qualitative synthesis and most studies were marked as low to moderate risk of bias in each domain of QUIPS. The most commonly used parameter was relative liver enhancement or its related parameters. The reported incidence of PHLF ranged from 3.9 to 40%. The predictive sensitivity and specificity of gadoxetic acid–enhanced MRI parameters varied from 75 to 100% and from 54 to 93% in ten reported studies. A majority of the studies revealed that the gadoxetic acid–enhanced MRI parameter was a predictor for PHLF. Conclusions Gadoxetic acid–enhanced MRI showed a high predictive capacity for PHLF and represents a promising imaging biomarker in prediction of PHLF. Multicenter, prospective trials with large sample size and reliable, unified liver function parameters are required to validate the efficacy of individual liver function parameters. Key Points • There is an obvious heterogeneity of the published studies, not only in variance of MRI liver function parameters but also in indication and extent of the liver resection. • Signal intensity (SI)–based parameters derived from gadoxetic acid–enhanced MRI are the commonly used method for PHLF prediction. • Gadoxetic acid–enhanced MRI-derived parameters showed high predictive efficacy for PHLF and can potentially serve as a predictor for the incidence of PHLF.

scholarly journals Impact of liver volume and liver function on posthepatectomy liver failure after portal vein embolization– A multivariable cohort analysis

2018 ◽  
Vol 25 ◽  
pp. 6-11 ◽  
Author(s):  
Patrick H. Alizai ◽  
Annabel Haelsig ◽  
Philipp Bruners ◽  
Florian Ulmer ◽  
Christian D. Klink ◽  
...  
Keyword(s):  
Liver Function ◽  
Portal Vein ◽  
Liver Failure ◽  
Portal Vein Embolization ◽  
Cohort Analysis ◽  
Liver Volume ◽  
Posthepatectomy Liver Failure

scholarly journals Interstage assessment of remnant liver function in ALPPS using hepatobiliary scintigraphy: prediction of posthepatectomy liver failure and introduction of the HIBA index

HPB ◽  
2017 ◽  
Vol 19 ◽  
pp. S83
Author(s):  
M. Serenari ◽  
C. Collaud ◽  
F. Alvarez ◽  
M. De Santibañes ◽  
D. Giunta ◽  
...  
Keyword(s):  
Liver Function ◽  
Liver Failure ◽  
Hepatobiliary Scintigraphy ◽  
Remnant Liver ◽  
Posthepatectomy Liver Failure ◽  
Remnant Liver Function

scholarly journals Correlation Between Portal Pressure and Indocyanine Green Retention Rate is Unaffected by the Cause of Cirrhosis: A Prospective Study

2021 ◽  
Author(s):  
Kosuke Kobayashi ◽  
Emilie Uldry ◽  
Takashi Kokudo ◽  
Alessandra Cristaudi ◽  
Yoshikuni Kawaguchi ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Liver Resection ◽  
Indocyanine Green ◽  
Retention Rate ◽  
Portal Pressure ◽  
Postoperative Outcomes ◽  
Accurate Estimation ◽  
Virus Group ◽  
Icg R15 ◽  
Indocyanine Green Retention Rate

Abstract Background Accurate estimation of the hepatic functional reserve before liver resection is important to avoid post-hepatectomy liver failure (PHLF). The aim of the present study was to evaluate the association of indocyanine green retention test with portal pressure by the cause of cirrhosis (non-viral vs. viral) and assessed postoperative outcomes including incidence of PHLF in patients with viral and non-viral cirrhosis. Methods The cohort includes 50 consecutive patients with liver cirrhosis scheduled for liver resection for primary liver tumors at the Lausanne University Hospital between 2009 and 2018. Results There were 31 patients with non-viral liver cirrhosis (Non-virus group) and 19 with viral liver cirrhosis (virus group). The indocyanine green retention rate at 15 min (ICG-R15) (p = 0.276), Hepatic Venous Portal Gradient (HVPG; p = 0.301), and postoperative outcomes did not differ between the non-virus group and viral group. ICG-R15 and HVPG showed a significant linear correlation in all patients (Spearman’s rank correlation coefficient, ρ = 0.599, p < 0.001), the non-virus group (ρ = 0.555, p = 0.026), and the virus group (ρ = 0.534, p = 0.007). A receiver operating characteristic curve analysis showed that ICG-R15 was a predictor for presence of portal hypertension (PH; HVPG ≥ 12 mmHg) (area under the curve [AUC] = 0.780). The cut-off value of ICG-R15 for predicting the presence of PH was 16.0% with 72.3% of sensitivity and 79.0% of specificity. Conclusions The ICG-R15 level was associated with portal pressure in both patients with non-virus cirrhosis and patients with virus cirrhosis and predicts the incidence of PH with relatively good discriminatory ability. Clinical trial number https://clinicalTrials.gov(ID:NCT00827723) Local ethics committee number CER-VD 251.08

scholarly journals A novel model for predicting posthepatectomy liver failure based on liver function and degree of liver resection in patients with hepatocellular carcinoma

HPB ◽  
2020 ◽  
Author(s):  
Naruhiko Honmyo ◽  
Tsuyoshi Kobayashi ◽  
Shintaro Kuroda ◽  
Akihiko Oshita ◽  
Takashi Onoe ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Liver Resection ◽  
Liver Function ◽  
Liver Failure ◽  
Posthepatectomy Liver Failure ◽  
Novel Model
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