Effect of Detection of ICGR15 During Hemihepatectomy for Patients with Primary Liver Carcinoma_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LU Sen , HUANG Xinli , LI Xiangcheng , WANG Xuehao

Liver Transplantation Center, The First Affiliated Hospital of Nanjing Medical University, Nanjing 210029, China;

Corresponding author：

Keywords：

Primary liver carcinoma; Liver reserve function; Retention rate of indocyanine green; Child-Pugh score; MELD score

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Objective To investigate the value of retention rate of indocyanine green at fifteen minutes (ICGR15) during hemihepatectomy for evaluation of residual liver reserve function in patients with primary liver carcinoma. Methods During hemihepatectomy, ICGR15 was tested in 44 patients after the hepatic artery and portal vein of resected side were ligated. Child-Pugh score, Child-Pugh classification, and MELD score before operation were tested. After operation, the liver function condition was estimated. Results The incidence of liver dysfunction was significantly lower in ICGR15 lt;10% group (17.9%, 5/28) than that in 10%~15% group (75.0%, 12/16), P lt;0.05. There was no significant difference of Child-Pugh score among normal liver function group, mild insufficiency of liver function group, and severe insufficiency of liver function group （P gt;0.05）. ICGR15 and MELD score in normal liver function group were statistical lower than those in mild insufficiency of liver function group and severe insufficiency of liver function group (P lt;0.05). ICGR15 was significantly lower in Child-Pugh A group than that in Child-Pugh B group (P lt;0.05). Conclusion Intraoperative residual liver ICGR15 may be more precisely compared with Child-Pugh score in evaluation liver reserve function for the patients with primary liver carcinoma and can help to guide liver resection.

Citation： LU Sen,HUANG Xinli,LI Xiangcheng,WANG Xuehao. Effect of Detection of ICGR15 During Hemihepatectomy for Patients with Primary Liver Carcinoma. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2010, 17(6): 543-546. doi: Copy

1.	Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11): 1798-1804.
2.	Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease [J]. Hepatology, 2001; 33(2): 464-470.
3.	谢建国，严律南. MELD评分系统在肝移植中的应用和意义 [J] . 中国普外基础与临床杂志, 2005; 12（6）： 634-636.
4.	王吉耀. 肝硬化 [A] . 见: 陈灏珠. 实用内科学 [M]. 第12 版. 北京: 人民卫生出版社, 2005: 1983-2000.
5.	崔书钟, 刘海鹰, 王斌, 等. 原发性肝癌患者肝储备功能的研究 [J]. 肿瘤防治杂志, 2003; 10(11): 1159-1160.
6.	Sakka SG. Assessing liver function [J]. Curr Opin Crit Care, 2007; 13(2): 207-214.
7.	潘飞, 陈大志, 盛勤松, 等. 吲哚氰绿(ICG)排泄试验和MELD评分 [J]. 肝胆外科杂志, 2008; 16(6): 440-441.
8.	劳向明, 张亚奇, 林小军, 等. 吲哚氰绿潴留率判断切肝量及其与肝癌术后肝功能不全的关系 [J]. 癌症, 2005; 24(3): 337-340.
9.	Fan ST. Methods and related drawbacks in the estimation of surgical risks in cirrhotic patients undergoing hepatectomy[J]．Hepatogastroenterology, 2002; 49(43): 17-20.
10.	Pan Z, Wu XJ, Li JS, et al . Functional hepatic flow in patients with liver cirrhosis [J] . World J Gastroenterol, 2004; 10(6): 915-918.
11.	元云飞, 李国辉, 李锦清, 等. 术前肝储备功能评估对原发性肝癌手术的价值 [J]. 中华肿瘤杂志, 1995; 17(5): 377-380.
12.	李哲夫, 陈孝平. 肝脏储备功能的检测方法及意义 [J]. 中华肝胆外科杂志, 2006; 12(10): 714-716.
13.	Faybik P, Hetz H. Plasma disappearance rate of indocyanine green in liver dysfunction [J]. Transplant Proc, 2006; 38(3): 801-802.
14.	杜正贵，李波，冯曦，等. 脉搏染料光密度法吲哚氰绿排泄试验对评价肝癌切除术后肝功能不全的价值 [J]. 中国普外基础与临床杂志, 2009; 16(2): 133-136.
15.	Szijártó A, Hargitai B, Fischer S, et al. Two-staged procedure of portal ligation and hepatectomy monitored by ICG clearance [J]. J Invest Surg, 2009; 22(1): 63-68.
16.	Mizushima Y, Tohira H, Mizobata Y, et al. Assessment of effective hepatic blood flow in critically ill patients by noninvasive pulse dye-densitometry [J]. Surg Today, 2003; 33(2): 101-105.
17.	任贵兵, 钱崇宽, 赵端仪, 等. D-山梨醇清除率法补充吲哚氰绿潴留率和Child-Pugh 分级评估肝储备功能 [J]. 中国普外基础与临床杂志, 2008; 15（4）： 271-273.
18.	Fazakas J, Mándli T, Ther G, et al. Evaluation of liver function for hepatic resection [J]. Transplant Proc, 2006; 38(3): 798-800.
19.	Tanaka S, Okamoto Y, Yamazaki M, et al. Significance of hyperglobulinemia in severe chronic liver diseases-with special reference to the correlation between serum globulin/IgG level and ICG clearance [J]. Hepatogastroenterology, 2007; 54(80): 2301-2305.
20.	Hsieh CB, Chen CJ, Chen TW, et al . Accuracy of indocyanine green pulse spectrophotometry clearance test for liver function prediction in transplanted patients [J]. World J Gastroenterol, 2004; 10(16): 2394-2396.
21.	Van Thiel DH, Wright HI, Fagiuoli S, et al. Preoperative evaluation of a patient for hepatic surgery [J]. J Surg Oncol Suppl, 1993; 3: 49-51.
22.	戴朝六. 肝脏储备功能的评估 [J]. 中国实用外科杂志, 2005; 25(12): 708-710.
23.	钱刚, 吴宝灵, 余海滨, 等. 肝脏储备功能检测在肝硬化诊疗中的临床应用 [J]. 实用临床医学， 2009; 10（1）： 22-24.
24.	Hsia CY, Lui WY, Chau GY, et al． Perioperative safety and prognosis in hepatocellular carcinoma patients with impaired liver function [J]． J Am Coll Surg, 2000; 190(5): 574-579.
25.	熊炬, 张金辉, 张朝霞, 等. 原发性肝癌患者术前肝储备功能的预测和术后评价 [J]. 肝胆外科杂志， 2007; 15（2）： 93-96.

1. Bambha K, Kim WR, Kremers WK, et al. Predicting survival among patients listed for liver transplantation: an assessment of serial MELD measurements [J]. Am J Transplant, 2004; 4(11): 1798-1804.
2. Kamath PS, Wiesner RH, Malinchoc M, et al. A model to predict survival in patients with end-stage liver disease [J]. Hepatology, 2001; 33(2): 464-470.
3. 谢建国，严律南. MELD评分系统在肝移植中的应用和意义 [J] . 中国普外基础与临床杂志, 2005; 12（6）： 634-636.
4. 王吉耀. 肝硬化 [A] . 见: 陈灏珠. 实用内科学 [M]. 第12 版. 北京: 人民卫生出版社, 2005: 1983-2000.
5. 崔书钟, 刘海鹰, 王斌, 等. 原发性肝癌患者肝储备功能的研究 [J]. 肿瘤防治杂志, 2003; 10(11): 1159-1160.
6. Sakka SG. Assessing liver function [J]. Curr Opin Crit Care, 2007; 13(2): 207-214.
7. 潘飞, 陈大志, 盛勤松, 等. 吲哚氰绿(ICG)排泄试验和MELD评分 [J]. 肝胆外科杂志, 2008; 16(6): 440-441.
8. 劳向明, 张亚奇, 林小军, 等. 吲哚氰绿潴留率判断切肝量及其与肝癌术后肝功能不全的关系 [J]. 癌症, 2005; 24(3): 337-340.
9. Fan ST. Methods and related drawbacks in the estimation of surgical risks in cirrhotic patients undergoing hepatectomy[J]．Hepatogastroenterology, 2002; 49(43): 17-20.
10. Pan Z, Wu XJ, Li JS, et al . Functional hepatic flow in patients with liver cirrhosis [J] . World J Gastroenterol, 2004; 10(6): 915-918.
11. 元云飞, 李国辉, 李锦清, 等. 术前肝储备功能评估对原发性肝癌手术的价值 [J]. 中华肿瘤杂志, 1995; 17(5): 377-380.
12. 李哲夫, 陈孝平. 肝脏储备功能的检测方法及意义 [J]. 中华肝胆外科杂志, 2006; 12(10): 714-716.
13. Faybik P, Hetz H. Plasma disappearance rate of indocyanine green in liver dysfunction [J]. Transplant Proc, 2006; 38(3): 801-802.
14. 杜正贵，李波，冯曦，等. 脉搏染料光密度法吲哚氰绿排泄试验对评价肝癌切除术后肝功能不全的价值 [J]. 中国普外基础与临床杂志, 2009; 16(2): 133-136.
15. Szijártó A, Hargitai B, Fischer S, et al. Two-staged procedure of portal ligation and hepatectomy monitored by ICG clearance [J]. J Invest Surg, 2009; 22(1): 63-68.
16. Mizushima Y, Tohira H, Mizobata Y, et al. Assessment of effective hepatic blood flow in critically ill patients by noninvasive pulse dye-densitometry [J]. Surg Today, 2003; 33(2): 101-105.
17. 任贵兵, 钱崇宽, 赵端仪, 等. D-山梨醇清除率法补充吲哚氰绿潴留率和Child-Pugh 分级评估肝储备功能 [J]. 中国普外基础与临床杂志, 2008; 15（4）： 271-273.
18. Fazakas J, Mándli T, Ther G, et al. Evaluation of liver function for hepatic resection [J]. Transplant Proc, 2006; 38(3): 798-800.
19. Tanaka S, Okamoto Y, Yamazaki M, et al. Significance of hyperglobulinemia in severe chronic liver diseases-with special reference to the correlation between serum globulin/IgG level and ICG clearance [J]. Hepatogastroenterology, 2007; 54(80): 2301-2305.
20. Hsieh CB, Chen CJ, Chen TW, et al . Accuracy of indocyanine green pulse spectrophotometry clearance test for liver function prediction in transplanted patients [J]. World J Gastroenterol, 2004; 10(16): 2394-2396.
21. Van Thiel DH, Wright HI, Fagiuoli S, et al. Preoperative evaluation of a patient for hepatic surgery [J]. J Surg Oncol Suppl, 1993; 3: 49-51.
22. 戴朝六. 肝脏储备功能的评估 [J]. 中国实用外科杂志, 2005; 25(12): 708-710.
23. 钱刚, 吴宝灵, 余海滨, 等. 肝脏储备功能检测在肝硬化诊疗中的临床应用 [J]. 实用临床医学， 2009; 10（1）： 22-24.
24. Hsia CY, Lui WY, Chau GY, et al． Perioperative safety and prognosis in hepatocellular carcinoma patients with impaired liver function [J]． J Am Coll Surg, 2000; 190(5): 574-579.
25. 熊炬, 张金辉, 张朝霞, 等. 原发性肝癌患者术前肝储备功能的预测和术后评价 [J]. 肝胆外科杂志， 2007; 15（2）： 93-96.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Effect of Detection of ICGR15 During Hemihepatectomy for Patients with Primary Liver Carcinoma

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