[Combined indocyanine green test and standard remnant liver volume to predict post-hepatectomy hepatic insufficiency for the patients with hepatocellular carcinoma].

Objective To discuss the safety line to avoid the post-hepatectomy hepatic insufficiency by combining indocyanine green test by pulse dye-densitometry (PDD-ICG) and standard remnant liver volume (SRLV). Methods Seventy-five hepatic cancer patients undergone hepatectomy from March 2007 to February 2008 were included. According to the liver function decompensatory grades after operation, the relationship between ICG retention rate at 15 min(ICGR15) and standard remnant liver volume by linear regression were analyzed. Results There were 60 cases with slight hepatic insufficiency, 12 cases with moderate hepatic insufficiency,and 3 cases with severe hepatic insufficiency. There were no difference in age [(50±13) years old and (53±9) years old], prothrombin time [(13.6±1.0)s and (13.5±1.0) s],international normalized ratio(1.09±0.10 and 1.06±0.10) between slight hepatic insufficiency group and moderate and severe hepatic insufficiency group(P>0.05). And there were difference in K value(0.20±0.04 and 0.17±0.03),ICGR15(6±4 and 9±4),SRLV[(545±93) ml and (398±82) ml]between two groups (P < 0.05). Compared ICG test and standard remnant liver volume of the patients with moderate hepatic insufficiency after operation, the liner relationship was found (R=0.640, P=0.025), and the regression equation was:standard remnant liver volume(ml/m~2)=1594.6×ICGRI5+265. Conclusions PDD-ICG test and standard remnant liver volume are effective to estimate hepatic function reserve of patient undergone hepatectomy. Key words: Hepatectomy; Liver neoplasms; Indocyanine green test; Standard remnant liver volume; Hepatic insufficiency