Preoperative indocyanine green (ICG) clearance test: Can we really trust it to predict post hepatectomy liver failure? A systematic review of the literature and meta-analysis of diagnostic test accuracy

吲哚青绿 医学 荟萃分析 肝切除术 肝衰竭 切除术 临床意义 外科 核医学 放射科 内科学
作者
Stefano Granieri,Greta Bracchetti,Alessia Kersik,Simone Frassini,Alessandro Germini,Alessandro Bonomi,Laura Lomaglio,Elson Gjoni,Alice Frontali,Federica Bruno,Sissi Paleino,Christian Cotsoglou
出处
期刊:Photodiagnosis and Photodynamic Therapy [Elsevier BV]
卷期号:40: 103170-103170 被引量:15
标识
DOI:10.1016/j.pdpdt.2022.103170
摘要

Post hepatectomy liver failure (PHFL) still represents a potentially fatal complication after major liver resection. Indocyanine green (ICG) clearance test represents one of the most widely adopted examinations in the preoperative workup. Despite a copious body of evidence which has been published on this topic, the role of ICG in predicting PHLF is still a matter of debate.A systematic review of the literature was conducted according to PRISMA-DTA guidelines. The primary outcome was the assessment of diagnostic performance of ICG in predicting PHLF. The secondary outcome was the mean ICGR15 and ICGPDR in patients experiencing PHLF.Seventeen studies, for a total of 4852 patients, were deemed eligible. Sensitivity ranged from 25% to 83%; Specificity ranged from 66.1% to 93.8%. ICG clearance test pooled AUC was 0.673 (95% CI: 0.632-0.713). The weighted mean ICGR15 was 11 (95%CI: 8.3-13.7). The weighted mean ICGPDR was 16.5 (95%CI: 13.3-19.8). High risk of bias was detected in all examined domains.Preoperative ICG clearance test alone may not represent a reliable method to predict post hepatectomy liver failure. Its diagnostic significance should be framed within multiparametric models involving clinical and imaging features.
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