Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma

作     者：Atsushi Miki Yasunaru Sakuma Hideyuki Ohzawa Akira Saito Yoshiyuki Meguro Jun Watanabe Kazue Morishima Kazuhiro Endo Hideki Sasanuma Atsushi Shimizu Alan Kawarai Lefor Yoshikazu Yasuda Naohiro Sata 

作者机构：Department of SurgeryJichi Medical UniversityShimotsuke 329-0498TochigiJapan 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2022年第28卷第38期

页      面：5614-5625页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

基　　金：The study was reviewed and approved by the Institutional Review Board of Jichi Medical University Approval No.A21-029. 

主　　题：Liver function Hepatectomy Cirrhosis Fusion image Complication Mortality 

摘      要：BACKGROUND Estimation of the functional reserve of the remnant liver is important to reduce morbidity and mortality.AIM To estimate the functional reserve of the remnant liver in patients with hepatocellular carcinoma(HCC).METHODS We reviewed the medical records of 199 patients who underwent resection of HCC.Hepatic clearance of the remnant liver was calculated using fusion images of 99mTc-labelled galactosyl-human serum albumin liver scintigraphy and computed tomography.Posthepatectomy liver failure(PHLF)was classified according to the International Study Group of Liver Surgery.Complications was classified according to Clavien–Dindo classification.We analyzed by the risk factors for PHLF,morbidity and mortality with multivariate analysis.RESULTS Twenty-seven(30%)patients had major complications and 23(12%)developed PHLF.The incidence of major complications increased with increasing albumin–bilirubin(ALBI)grade.The area under the curve values for hepatic clearance of the remnant liver,liver to heart-plus-liver radioactivity at 15 min(LHL15),and ALBI score predicting PHLF were 0.868,0.629,and 0.655,respectively.The area under the curve for hepatic clearance of the remnant liver,LHL15,and ALBI score predicting major complications were 0.758,0.594,and 0.647,respectively.The risk factors for PHLF and major complications were hepatic clearance of the remnant liver and intraoperative bleeding.CONCLUSION The measurement of hepatic clearance may predict PHLF and major complications for patients undergoing resection of HCC.