Predictors of successful hepatic resection: Prognostic usefulness of hepatic asialoglycoprotein receptor analysis

Kokudo, Norihiro; Vera, David R.; Tada, Keiichiro; Koizumi, Mitsuru; Seki, Makoto; Matsubara, Toshiki; Ohta, Hiroyuki; Yamaguchi, Toshiharu; Takahashi, Takashi; Nakajima, Toshifusa; Muto, Tetsuichiro

doi:10.1007/s00268-002-6262-3

Cited by 76 publications

(63 citation statements)

References 24 publications

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“…This receptor-targeted liver function test (28-31) correlated well with ICG clearance and conventional liver function parameters (28,30). In several studies, the test also seems to have predictive value for short-term outcome (29,31). However, ROC analysis was never performed in these studies.…”

Section: Discussionmentioning

confidence: 99%

Risk Assessment of Posthepatectomy Liver Failure Using Hepatobiliary Scintigraphy and CT Volumetry

Dinant

Graaf²,

Verwer³

et al. 2007

Journal of Nuclear Medicine

148

119

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A major part of morbidity and mortality after liver resections is caused by inadequate remnant liver function leading to liver failure. It is therefore important to develop accurate diagnostic tools that can predict the risk of liver resection-related morbidity and mortality. In this study, preoperative hepatobiliary scintigraphy of the future remnant liver and CT volumetric measurement of the future remnant liver were performed on patients who were to undergo liver resection. The accuracy of risk assessment for postoperative morbidity, liver failure, and mortality was evaluated. Methods: Forty-six patients who were scheduled for liver resection because of hepatobiliary tumors, including 17 patients with parenchymal disease (37%) and 13 patients with hilar cholangiocarcinoma (28%), were assessed preoperatively. Hepatobiliary scintigraphy was performed by drawing regions of interest around the future remnant to calculate 99m Tc-mebrofenin uptake in it. CT volumetry was used to measure the volume of the total liver, the tumors, and the future remnant. Receiver-operatingcharacteristic analysis was performed to assess cutoff values for risk assessment of morbidity, liver failure, and mortality. Furthermore, univariate and multivariate analyses were performed to determine factors related to morbidity and mortality. Results: Morbidity and mortality rates were 61% and 11%, respectively. Liver failure occurred in 6 patients (13%). Significantly decreased uptake in the future remnant was found in patients in whom liver failure and liver failure-related mortality developed (P 5 0.003 and 0.02, respectively). The volume of the future remnant was not significantly associated with any of the outcome parameters. In receiver-operating-characteristic analysis, uptake cutoff values for liver failure and liver failure-related mortality were 2.5%/min/ body surface area and 2.2%/min/body surface area, respectively. In multivariate analysis, uptake was the only significant factor associated with liver failure. Conclusion: Preoperative measurement of 99m Tc-mebrofenin uptake in the future remnant liver on hepatobiliary scintigraphy proved more valuable than measurement of the volume of the future remnant on CT in assessing the risk of liver failure and liver failure-related mortality after partial liver resection.

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Section: Discussionmentioning

confidence: 99%

Risk Assessment of Posthepatectomy Liver Failure Using Hepatobiliary Scintigraphy and CT Volumetry

Dinant

Graaf²,

Verwer³

et al. 2007

Journal of Nuclear Medicine

148

119

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“…Multiple studies have described the application of preoperative planar dynamic 99m Tc-GSA scintigraphy for predicting postoperative complications (31,(48)(49)(50). Preoperative GSA R max and LHL15 proved to be reliable indicators for predicting postoperative complications in patients with hepatocellular carcinoma and chronic liver disease, because significantly lower values were found in patients with major postoperative complications (30,50).…”

Section: Kinetics and Quantitative Measurement Of Liver Functionmentioning

confidence: 99%

Nuclear Imaging Techniques for the Assessment of Hepatic Function in Liver Surgery and Transplantation

Graaf¹,

Bennink²,

Veteläinen³

et al. 2010

J Nucl Med

138

120

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This review describes the application of 2 nuclear imaging techniques for assessment of hepatic function in the setting of liver surgery and transplantation. The biochemical and technical background, as well as the clinical applications, of 99m Tc-labeled diethylenetriaminepentaacetic acid galactosyl human serum albumin (GSA) scintigraphy and hepatobiliary scintigraphy (HBS) with 99m Tc-labeled iminodiacetic acid derivates is discussed. 99m Tc-mebrofenin is considered the most suitable iminodiacetic acid agent for 99m Tc-HBS. 99m Tc-GSA scintigraphy and 99m Tcmebrofenin HBS are based on 2 different principles. 99m Tc-GSA scintigraphy is a receptor-mediated technique whereas HBS represents hepatic uptake and excretion function. Both techniques are noninvasive and provide visual and quantitative information on both total and regional liver function. They can be used for preoperative assessment of future remnant liver function, follow-up after preoperative portal vein embolization, and evaluation of postoperative liver regeneration. In liver transplantation, these methods are used to assess graft function and biliary complications.

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“…However, in patients with liver dysfunction, such as cirrhosis and obstructive jaundice, and in those who undergo extended major hepatectomy, the operative risk is significant and should be carefully evaluated before surgery [2,3].…”

Section: Introductionmentioning

confidence: 99%

Functional liver reserve parameters predictive for posthepatectomy complications

Nanashima

Abo

Arai

et al. 2013

Journal of Surgical Research

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Abstract.Background: Posthepatectomy complications have markedly decreased with advances in techniques and management; however, surgical risk to patients with injured livers is still not negligible. We evaluated several preoperative parameters of functional liver reserve tests in patients with various liver diseases as predictors HH15, bilirubin level, HA, and major hepatectomy were parameters included in the predictive formula. Conclusions: in this study, we present a comprehensive formula based on predictive parameters for hepatic complications for prospective assessment to avoid post-hepatectomy morbidity.

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Predictors of successful hepatic resection: Prognostic usefulness of hepatic asialoglycoprotein receptor analysis

Cited by 76 publications

References 24 publications

Risk Assessment of Posthepatectomy Liver Failure Using Hepatobiliary Scintigraphy and CT Volumetry

Risk Assessment of Posthepatectomy Liver Failure Using Hepatobiliary Scintigraphy and CT Volumetry

Nuclear Imaging Techniques for the Assessment of Hepatic Function in Liver Surgery and Transplantation

Functional liver reserve parameters predictive for posthepatectomy complications

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