ICG Pulse Spectrophotometry for Perioperative Liver Function in Hepatectomy

Okochi, Osamu; Kaneko, Tetsuya; Sugimoto, Hiroyuki; Inoue, Soichiro; Takeda, Shin; Nakao, Akimasa

doi:10.1006/jsre.2001.6328

Cited by 102 publications

(65 citation statements)

References 18 publications

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“…The combination of %FRL-V acquired from CeCT volumetry with the TL-F from the HBS resulted in a clear underestimation of postoperative remnant liver function. CT volumetry is sometimes combined with TL-F measured by indocyanine green (ICG) clearance test (18,19). Because the ICG clearance test also represents global liver function, this could result in a wrong representation of the FRL-F in a liver with potentially inhomogeneous distribution of function.…”

Section: Discussionmentioning

confidence: 99%

^99mTc-Mebrofenin Hepatobiliary Scintigraphy with SPECT for the Assessment of Hepatic Function and Liver Functional Volume Before Partial Hepatectomy

Graaf¹,

Lienden²,

Gulik³

et al. 2010

J Nucl Med

152

127

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Preoperative evaluation of future remnant liver (FRL) function is crucial in the determination of whether a patient can safely undergo liver resection. Although dynamic 99m Tc-mebrofenin hepatobiliary scintigraphy (HBS) is used to measure FRL function, 2-dimensional planar images lack the ability to assess segmental liver function. Modern SPECT/CT cameras combine dynamic 99m Tc-mebrofenin HBS with additional SPECT and the anatomic information of the CT scan. The aim of this study was to evaluate the additional value of 99m Tc-mebrofenin SPECT for the measurement of segmental liver function and liver functional volume. Methods: Preoperative CT volumetry and 99m Tc-mebrofenin HBS with SPECT were performed in 36 patients undergoing liver resection. In 18 patients, postoperative 99m Tc-mebrofenin HBS with SPECT was performed within 3 d after operation. Dual-head dynamic acquisitions were used to calculate FRL function using anterior and geometric mean (Gmean) datasets. Total and FRL functional liver volumes were measured by SPECT. Results: Because of the anatomic position of the liver, the anterior projection resulted in an underestimation of FRL function in patients undergoing left hemihepatectomy. In patients with normal liver parenchyma, total functional liver volume was comparable to total liver volume measured by CT volumetry, indicating that 99m Tc-mebrofenin SPECT is an accurate method to measure hepatic volume. In compromised livers, compared with normal livers, FRL function per cubic centimeter of liver volume was significantly less. In addition, liver function was not distributed homogeneously, with the segments to be resected relatively more affected. FRL function, measured by a combination of SPECT and dynamic HBS, was able to accurately predict actual postoperative remnant liver function. Conclusion: The Gmean dataset is recommended for the assessment of hepatic function by dynamic planar 99m Tc-mebrofenin HBS. The combination of SPECT data with the dynamic uptake function measured by planar HBS provides valuable visible and quantitative information regarding segmental liver function and is an accurate measure for FRL function.

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Section: Discussionmentioning

confidence: 99%

^99mTc-Mebrofenin Hepatobiliary Scintigraphy with SPECT for the Assessment of Hepatic Function and Liver Functional Volume Before Partial Hepatectomy

Graaf¹,

Lienden²,

Gulik³

et al. 2010

J Nucl Med

152

127

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“…Briefly, ICG was intravenously administered at a dose of 0.5 mg/kg, monitoring the blood concentration of ICG to determine the plasma disappearance rate (PDR, %/min). It was considered that the ICG clearance was altered when PDR was < 15%, and severely altered when PDR was < 10% [34,35] . Pancreatic fecal elastase-E1 activity was determined by ELISA (Pancreatic Elastase stool test, Schebo-Biotech, Giessen RFA).…”

Section: Methodsmentioning

confidence: 99%

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

Aparisi¹,

Sabater²,

Del-Olmo³

et al. 2008

WJG

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AIM:To study the possible association between chronic pancreatitis (CP) and liver cirrhosis (LC) of alcoholic etiology, after excluding any other causes. METHODS: One hundred and forty consecutive alcoholic patients were subdivided into three groups: CP (n = 53), LC (n = 57), and asymptomatic alcoholic (n = 30). Clinical, biochemical and morphological characteristics, Child-Pugh index, indocyanine green test, and fecal pancreatic elastase-1 test were assessed. RESULTS: In patients with cirrhosis, major clinical manifestations of CP such as pancreatic pain and steatorrhea, as well as imaging alterations of CP such as calcifications, duct dilation and pseudocysts were absent; insulin-dependent diabetes was present in 5.3% of cases, and elastase-1 test was altered in only 7%, and severely altered in none. In patients with CP, clinical characteristics of cirrhosis such as ascites, encephalopathy and gastrointestinal hemorrhage were present in one case, Child-Pugh grade > A in 5.7%, and altered indocyanine green test in 1.9% cases. In asymptomatic alcoholism, there was only a non-coincident alteration of elastase-1 test and indocyanine test in 14.8% and 10%, respectively, but other characteristics of cirrhosis or CP were absent. An inverse correlation (r = -0.746) between elastase-1 test and indocyanine test was found in alcoholic patients. CONCLUSION:There is a scarce coincidence in clinical and morphological alterations among patients with CP or LC of alcoholic etiology, but an inverse correlation between pancreatic and liver function tests. These findings support that these alcoholic diseases evolve in a different manner and have different etiopathogenesis.

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“…Liver dysfunction was quantified pre-operatively and on day 2 after surgery by indocyanine green elimination rate (ICG-15) measured by pulse dyedensitometry, as described by Okochi et al [13]. The time to the first postoperative dose of analgesics or first use of the PCA device was recorded.…”

Section: Methodsmentioning

confidence: 99%

The analgesic efficacy of continuous wound instillation with ropivacaine after open hepatic surgery

Chan

Lai

Li³

et al. 2010

Anaesthesia

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SummaryThe analgesic efficacy of continuous local anaesthetic wound instillation after open hepatic surgery was evaluated. Forty-eight patients scheduled for elective liver surgery were assigned to receive either ropivacaine 0.25% or saline infusion at 4 ml.h)1 for 68 h via two multi-orifice indwelling catheters placed within the musculo-fascial layer before skin closure; plasma ropivacaine concentrations were measured during the infusion. Supplemental analgesia was provided by intravenous patient-controlled analgesia morphine. Patients in the ropivacaine group had decreased mean (SD) total morphine consumption (58 (30) mg vs 86 (44) mg, p = 0.01) and less pain at rest as well as after spirometry at 4, 12, 24, 48 and 72 h postoperatively (p < 0.01). Forced vital capacity was reduced postoperatively in both groups, but the reduction was greater in the saline group at 12 and 24 h (p = 0.03). The mean plasma concentration of ropivacaine increased to 2.05 (0.78) lg.ml )1 at the point when the infusion was terminated.

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ICG Pulse Spectrophotometry for Perioperative Liver Function in Hepatectomy

Cited by 102 publications

References 18 publications

^99mTc-Mebrofenin Hepatobiliary Scintigraphy with SPECT for the Assessment of Hepatic Function and Liver Functional Volume Before Partial Hepatectomy

^99mTc-Mebrofenin Hepatobiliary Scintigraphy with SPECT for the Assessment of Hepatic Function and Liver Functional Volume Before Partial Hepatectomy

Does an association exist between chronic pancreatitis and liver cirrhosis in alcoholic subjects?

The analgesic efficacy of continuous wound instillation with ropivacaine after open hepatic surgery

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