Preoperative evaluation of hepatic functional reserve following hepatectomy by technetium-99m galactosyl human serum albumin liver scintigraphy and computed tomography

Mitsumori, Akihito; Nagaya, Isao; Kimoto, Shin; Akaki, Shiro; Togami, Izumi; Takeda, Yoshihiro; Joja, Ikuo; Hiraki, Yoshio

doi:10.1007/s002590050311

Cited by 74 publications

(75 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The present study applied the reliable liver function markers from 99m Tc-GSA liver scintigraphy, ICGR15, and serum HA level, along with conventional parameters [12,13,16,17]. These noninvasive tests can be routinely performed before hepatectomy.…”

Section: Discussionmentioning

confidence: 99%

“…The present study examined relationships between reliable parameters of functional liver reserve such as conventional liver function tests, the indocyanine green (ICG) clearance test [11], serum hyaluronic acid (HA) level [12], and 99m Tc-galactosyl human serum albumin liver scintigraphy ( 99m Tc-GSA scintigraphy) [13] in 93 patients with various liver diseases in whom PP was directly measured. Furthermore, we attempted to derive a comprehensive analytical formula by multivariate analysis to predict PP and then compared predictive PP and true PP.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

et al. 2014

View full text Add to dashboard Cite

Portal hypertension is a major risk factor for hepatic failure or intestinal bleeding in patients with liver disease but cannot be measured indirectly. We attempted to comprehensively evaluate preoperative parameters of functional liver reserve that correlated with portal pressure (PP) in patients with various liver diseases. We examined 93 patients in whom portal pressure was directly measured during preoperative portal vein embolization (PVE) or operation. Background liver included chronic viral liver disease in 43 patients, obstructive jaundice in 29 patients, and normal liver in 21. Multivariate logistic analysis and linear regression analysis were applied to create a predictive formula for PP. Mean PP was 13.4±4.9 cm H 2 O, and PP was significantly associated with severity of liver injury, hepatic fibrosis, intraoperative blood loss, and post-hepatectomy morbidity (p<0.05 each). Mean PP after PVE (22.5±7.8 cm H 2 O) was significantly increased compared to that before embolization (13.1 ± 4.7 cm H 2 O; p<0.01). Univariate analysis identified seven significant parameters of preoperative liver function associated with PP: indocyanine green (ICG) test result, liver uptake and clearance index (HH15) on 99m Tc-galactosyl serum albumin liver scintigraphy, total bilirubin level, prothrombin activity, and hyaluronate level. Using multiple linear regression analysis, the predictive formula using ICG and HH15 was as follows: Y (estimated PP)=0.273+0.086×ICGR15+ 0.193×HH15. The calculated PP (11.5±4.6 cm H 2 O (−1.9 cm H 2 O)) was lower than true PP, which was significantly associated with post-hepatectomy morbidity (p<0.05). The correlation between true and calculated PP was weak, and prediction using the conventional liver functional parameters was limited at present and, however, estimating PP appears to be useful in evaluating portal hypertension and post-hepatectomy morbidity.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

et al. 2014

View full text Add to dashboard Cite

show abstract

“…The accuracy of determining the flow Doppler by IOUS is high (4,5). The flow Doppler's ultrasonographic parameters reflect the dynamics of the hepatic inflow and outflow, which may be associated with both the PP and the background liver status [13,14]. To the best of our knowledge, no indirect prediction of PP using ultrasonographic parameters has yet been reported.…”

Section: Introductionmentioning

confidence: 99%

Prediction of portal pressure from intraoperative ultrasonography

Nanashima

Abo

Arai

et al. 2014

Journal of Surgical Research

View full text Add to dashboard Cite

Background: Portal hypertension is a major risk factor for hepatic failure or bleeding in patients who have undergone hepatectomy, but it cannot be measured indirectly. We attempted to evaluate the intra-operative ultrasonography parameters that correlate with portal pressure (PP) in patients undergoing hepatectomy. Methods:We examined 30 patients in whom portal pressure was directly measured during surgery. The background liver conditions included chronic viral liver disease in seven patients, chemotherapy associated steatohepatitis in four patients, fatty liver in one patient, hepatolithiasis in one patient, obstructive jaundice in one patient and a normal liver in 16 patients. A multivariate logistic analysis and linear regression analysis were conducted to develop a predictive formula for PP. Conclusion:This formula, which uses ultrasonographic Doppler flow parameters, appears to be useful for predicting portal pressure.

show abstract

“…Therefore, other reliable functional parameters were needed. Recently, novel tests of FLR, such as serum HA level (13 -15), GSA scintigraphy (16), and interleukin levels (17), have been used to evaluate post-surgical complications. Furthermore, the correlation of LHL15 and HH15 to ICGR15 using a linear regression model and the analysis of individual liver segments by dynamic SPECT are easy and convenient methods for predicting hepatic functional reserve by GSA scintigraphy (18)(19)(20)(21).…”

Section: Introductionmentioning

confidence: 99%

Treatment strategy for successful hepatic resection of icteric liver

et al. 2018

View full text Add to dashboard Cite

: Background : The treatment strategy for jaundiced patients with hilar cholangiocarcinoma (HC) is not well established. In this study, we evaluate the feasibility of our perioperative protocol for jaundiced patients with HC. Methods : Twenty patients with HC who underwent hepatic resection at our institute were enrolled, and patients were divided into icteric(n=6) and normal(n=14) group. As a perioperative protocol, Oral administration of Inchinkoto(ICKT), steroid and nafamostat mesilate were introduced. The evaluation of functional future remnant liver(FRL) by asiaroscintigraphy, and postoperative outcomes were retrospectively compared. Results : Indocyanine green dye retention rate at 15 minutes was higher, and LHL15 values was lower in icteric group. However, in the functional evaluation of FRL, which was the sum of GSA uptake of the future FRL, there was no significant difference of LHL15 values of the remnant liver functional reserve between the two groups. As results, according to the difference of liver function, serum AST level was not different between two groups. The number of patients with postoperative morbidity in the two groups was comparable. Conclusions : Even in HC patients with icteric liver, accurate assessment of liver functional reserve and effective perioperative treatment may attribute to successful hepatectomy and favorable post-operative outcomes.

show abstract

Preoperative evaluation of hepatic functional reserve following hepatectomy by technetium-99m galactosyl human serum albumin liver scintigraphy and computed tomography

Cited by 74 publications

References 7 publications

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

Comprehensive Predictors of Portal Pressure from Functional Liver Reserve in Patients Who Underwent Hepatectomy

Prediction of portal pressure from intraoperative ultrasonography

Treatment strategy for successful hepatic resection of icteric liver

Contact Info

Product

Resources

About