Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test

Imamura, Hiroshi; Sano, Keiji; Sugawara, Yasuhiko; Kokudo, Norihiko; Makuuchi, Masatoshi

doi:10.1007/s00534-004-0965-9

Cited by 318 publications

(256 citation statements)

References 35 publications

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“…Indocyanine green (ICG) clearance and ICG retention rate at 15 min (ICG R15) in patients with chronic liver disease are thought to reflect the degree of sinusoidal capillarization, intrahepatic portovenous shunt and alteration in liver blood flow (11)(12)(13) . Thus ICG clearance test has been widely used to assess liver function reserve in patients with chronically reduced hepatic function (hepatitis, cirrhosis), evaluation of liver function in organ donors and recipients and critically ill patients.…”

Section: Introductionmentioning

confidence: 99%

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Carino

O’Reilly

Dajani

et al. 2009

European Journal of Surgical Oncology (EJSO)

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Section: Introductionmentioning

confidence: 99%

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Carino

O’Reilly

Dajani

et al. 2009

European Journal of Surgical Oncology (EJSO)

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“…The ICG is detectable in the bile 15 min after injection, with a maximum concentration between 30 min and 2 h after injection, depending on the amount injected. The kinetics of ICG plasma disappearance has been described in previous articles [20,21]. Because of the ICG metabolism, a dynamic test has been used largely to assess hepatic function as well as portal and hepatosplanchnic blood flow [10,22,23].…”

Section: Discussionmentioning

confidence: 99%

Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG‐Clearance

Tralhão

Hoti

Oliveiros³

et al. 2009

World j. surg.

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Background Intermittent Pringle maneuver or selective portal clamping often are used to control inflow during parenchymal liver transection. This study was designed to determinate whether these maneuvers are associated with adverse hepatic function. Methods Resection was performed without portal clamping in 17 patients (group 1). Selective continuous portal clamping was performed in 11 patients (group 2) and the remaining 33 patients (group 3) had intermittent nonselective portal clamping (occlusion of the main portal trunk). The centers' protocol for total portal occlusion is 15-min occlusion alternated with 5-min reperfusion in patients with normal liver parenchyma or 10 min alternated with 5 min in patients with abnormal parenchyma. ICG elimination tests were conducted concurrently using a noninvasive monitor that tracks the plasma disappearance rate (PDR-ICG-%/min) and 15-min retention rate after administration (ICG-R15-%). Results There was no statistically difference between the three studied groups in terms of sequential changes of ICG-PDR (p \ 0.625) or ICG-R15 (p \ 0.398).Conclusions Our study indicates that 15 min of intermittent Pringle maneuver or selective hemihepatic continuous portal clamping are safe methods of vascular control during liver resection, with no adverse effects on hepatocellular function.

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“…These scores should be assessed throughout the patient's admission because rapid deterioration indicates that surgery may not be safe. The value of indocyanine green plasma disappearance rate has been demonstrated in patients with LC undergoing cardiac surgery [19,20] and partial hepatectomy [21] , and it may be useful for assessing liver functional reserve in this scenario.…”

Section: Liver Functionmentioning

confidence: 99%

Outcomes of abdominal surgery in patients with liver cirrhosis

López-Delgado

Ballús

Esteve

et al. 2016

WJG

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Patients suffering from liver cirrhosis (LC) frequently require non-hepatic abdominal surgery, even before liver transplantation. LC is an important risk factor itself for surgery, due to the higher than average associated morbidity and mortality. This high surgical risk occurs because of the pathophysiology of liver disease itself and to the presence of contributing factors, such as coagulopathy, poor nutritional status, adaptive immune dysfunction, cirrhotic cardiomyopathy, and renal and pulmonary dysfunction, which all lead to poor outcomes. Careful evaluation of these factors and the degree of liver disease can help to reduce the development of complications both during and after abdominal surgery. In the emergency setting, with the presence of decompensated LC, alcoholic hepatitis, severe/advanced LC, and significant extrahepatic organ dysfunction conservative management is preferred. A multidisciplinary, individualized, and s p e c i a l i z e d a p p r o a c h c a n i m p r o v e o u t c o m e s ; preoperative optimization after risk stratification and careful management are mandatory before surgery. Laparoscopic techniques can also improve outcomes. We review the impact of LC on surgical outcome in non-hepatic abdominal surgeries required in this cirrhotic population before, during, and after surgery.Key words: Liver cirrhosis; Outcomes; Coagulopathy; Nutritional status; Abdominal surgery; Adaptive levels of expertise of the surgeons, anesthetists, and intensive care unit (ICU) staff. Liver function is usually assessed by the Child-Turcott-Pugh (CTP) and Model for End-Stage Liver Disease (MELD) scores [11] . Early studies found 30 d mortality rates after surgery were 10% in CTP-A, 30% in CTP-B, and 76%-82% in CTP-C, figures that have not significantly changed in more recent assessments [12,13] . Despite the poor results, advances in the medical management of LC and life expectancy have increased the eligibility of these patients for abdominal surgery [14] . To be able to give definitive recommendations and indications for non-hepatic abdominal surgery in the cirrhotic population, it is important to identify the patients most likely to benefit from it. There is also a need to assess contemporary surgical techniques and the various scoring systems currently in use.This review summarizes the outcomes of patients with LC undergoing non-hepatic abdominal surgery. Indexed articles in Medline of series of patients with LC who underwent non-hepatic abdominal surgery between 1950 and March 2014 were reviewed using the OVID interface. We aimed to select manuscripts addressing outcome based on the degree of LC assessed with MELD and/or CTP scores. Articles addressing the pathophysiology of cirrhotic patients and the clinical implications in non-hepatic abdominal surgery were selected based on their importance, their date of publication, and the citations of the manuscripts. As for articles describing the different types of surgery in LC patients, the most recent publications were selected in order to preser...

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Assessment of hepatic reserve for indication of hepatic resection: decision tree incorporating indocyanine green test

Cited by 318 publications

References 35 publications

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure

Intermittent Pringle Maneuver and Hepatic Function: Perioperative Monitoring by Noninvasive ICG‐Clearance

Outcomes of abdominal surgery in patients with liver cirrhosis

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