The value of indocyanine green clearance measurement in predicting liver function in patients undergoing anatomical hepatectomy

Abstract

Abstract: Objective To predict the liver function after anatomical hepatectomy by measuring the clearance rate of indocyanine green (ICG).Methods From September 2016 to September 2019, 68 patients who underwent anatomical hepatectomy, including 51 males and 17 females, with an average age of (49.8±10.2) years, were enrolled in our study. All patients underwent ICG clearance test and were pathologically diagnosed as primary hepatocellular carcinoma. The measurement data were expressed as (±s) and analyzed by t-test. Pearson correlation analysis was used to investigate the correlation between ICG retention rate at 15 minutes (ICG-R15) and observational data. Logistic regression model was used to identify the independent risk factors for postoperative liver insufficiency. Results The patients were divided into 2 groups: normal liver function group (n = 52) and liver insufficiency group (n = 16). There was no significant difference in age, platelet, total bilirubin, alanine aminotransferase, aspartate aminotransferase, prealbumin, prothrombin time international normalized ratio, operation time and preoperative ICG-R15 between the 2 groups. There were significant differences in intraoperative blood loss, intraoperative ICG-R15 and resected liver volume (P<0.05). Intraoperative ICG-R15 was significantly higher than preoperative ICG-R15 [(14.5±7.0)%, (6.8±5.5)%, P<0.05]. Pearson correlation analysis suggested that preoperative ICG-R15, intraoperative bleeding and resected liver volume had significant correlation with intraoperative ICG-R15 (correlation coefficients were 0.49, 0.72 and 0.60, respectively, P<0.05). Logistic regression analysis suggested that intraoperative ICG-R15 and resected liver volume were independent risk factors for liver insufficiency after anatomical hepatectomy, while preoperative ICG-R15 and intraoperative bleeding were not.Conclusion ICG clearance rate measurement is helpful to predict the state of liver function after anatomical hepatectomy. Intraoperative ICG-R15 is an independent risk factor for postoperative liver insufficiency.

Key words: Anatomical hepatectomy, Indocyanine green clearance rate, Hepatic insufficiency, Logistic regression model

DAI Bing, ZHANG Lin-jiao, LIU Chi, YANG Qi, LV Xin-yuan, WANG Lei. The value of indocyanine green clearance measurement in predicting liver function in patients undergoing anatomical hepatectomy[J]. Chinese Hepatolgy, 2020, 25(5): 480-482.

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