ObjectiveTo analyze factors affecting post-hepatectomy liver failure (PHLF) of patients with hepatocellular carcinoma (HCC) and explore value of combining albumin-bilirubin (ALBI) score with standardized future liver remnant (sFLR) in prediction of PHLF.MethodsThe clinical data of patients with HCC underwent curative hepatectomy in the Second and the Fifth Departments of General Surgery of the First Hospital of Lanzhou University from January 2016 to June 2018 were retrospectively reviewed. The risk factors of PHLF were identified through the logistic regression, the area under the receiver operating characteristic curve (AUC) was used to analyze the predictive value of the ALBI score, sFLR, or ALBI score×sFLR.ResultsA total of 72 patients with HCC were enrolled, all of them were the Child-Pugh A grade. The incidence of PHLF was 27.78% (20/72) in these 72 patients with HCC, which was 12.96% (7/54) and 72.22% (13/18) in the 54 patients with ALBI- Ⅰ grade and 18 patients with ALBI- Ⅱ grade respectively, the difference was statistically significant (P<0.001). The results of multivariable analysis of PHLF showed that the PLT (OR=0.030, P=0.018), ALBI grade (OR=11.758, P=0.020), and sFLR (OR=0.835, P=0.003) were identified as the independent predictors of PHLF. The AUC for the ALBI score×sFLR in predicting the PHLF was 0.892, it was greater than that of the ALBI score (AUC=0.799) or the sFLR (AUC=0.773).ConclusionCompared with Child-pugh grade, ALBI grade is more accurate in predicting PHLF of HCC patients, and combining ALBI score with sFLR is better than sFLR or ALBI score alone in predicting PHLF of patients with HCC.
ObjectiveTo introduce the basic principles of commonly used assessment methods for liver function reserve, and compare the advantages and disadvantages of various assessment methods, so as to provide a reference for hepatectomy of patients with hepatocellular carcinoma (HCC). MethodThe literature on evaluation methods of liver reserve function in patients with HCC at home and abroad in recent years was searched and summarized. ResultsFrom the results of literature review, the Child‐Pugh score and indocyanine green discharge test were the most commonly used to assess preoperative liver function reserve for patients with HCC. The application value of other examinations such as albumin-bilirubin score, gadolinium-ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (Gd-EOB-DTPA-enhanced MRI), nuclear medical imaging in predicting post-hepatectomy liver failure was gradually being explored. ConclusionsThe combination of clinical parameters and volumetric studies is used to assess preoperative liver function reserve for patients with HCC. The clinical applications of nuclear medical imaging and Gd-EOB-DTPA-enhanced MRI make up for the deficiency of local liver function reserve evaluation, which are important examinations to assess liver function reserve after conversion therapy in the future. However, more domestic studies are still needed to confirm their values.