Korean J Hepatobiliary Pancreat Surg.  2011 Feb;15(1):1-6.

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 CY
• Hwang YJ
• Chun JM
• Kwon HJ
• Son JH
• Kim SG
• Yun YK

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 (> or =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.

Keyword

Hepatocellular carcinoma; Hepatectomy; Hepatic failure; Esophageal varix

MeSH Terms

Carcinoma, Hepatocellular
Esophageal and Gastric Varices
Hepatectomy
Humans
Indocyanine Green
Liver
Liver Failure
Prothrombin
Retention (Psychology)
Risk Factors
Indocyanine Green
Prothrombin