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Perioperative liver and spleen elastography in patients without chronic liver disease

World Journal of Gastrointestinal Surgery 2018年第2期10卷 21-27页

作者： Sam Eriksson Hanna Borsiin Carl-Fredrik Oerg Hannes Brange Zoran Mijovic christian sturesson Department of Surgery Lund UniversitySkae University HospitalLund S-221 85Sweden Department of Radiology Lund UniversitySkae University HospitalLund S-221 85Sweden

AIM To investigate changes in hepatic and splenic stiffness in patients without chronic liver disease during liver resection for hepatic tumors.METHODS Patients scheduled for liver resection for hepatic tumors were considered for enrollment. Tissue stiffness measurements on liver and spleen were conducted before and two days after liver resection using point shear-wave elastography. Histological analysis of the resected liver specimen was conducted in all patients and patients with marked liver fibrosis were excluded from further study analysis. Patients were divided into groups depending on size of resection and whether they had received preoperative chemotherapy or not. The relation between tissue stiffness and postoperative biochemistry was investigated. RESULTS Results are presented as median(interquartile range). 35 patients were included. The liver stiffness increased in patients undergoing a major resection from 1.41(1.24-1.63) m/s to 2.20(1.72-2.44) m/s(P = 0.001). No change in liver stiffness in patients undergoing a minor resection was found [1.31(1.15-1.52) m/s vs 1.37(1.12-1.77) m/s, P = 0.438]. A major resection resulted in a 16%(7%-33%) increase in spleen stiffness, more(P = 0.047) than after a minor resection [2(-1-13) %]. Patients who underwent preoperative chemotherapy(n = 20) did not differ from others in preoperative right liver lobe [1.31(1.16-1.50) vs 1.38(1.12-1.56) m/s, P = 0.569] or spleen [2.79(2.33-3.11) vs 2.71(2.37-2.86) m/s, P = 0.515] stiffness. Remnant liver stiffness on the second postoperative day did not show strong correlations with maximum postoperative increase in bilirubin(R^2 = 0.154, Pearson's r = 0.392, P = 0.032) and international normalized ratio(R^2 = 0.285, Pearson's r = 0.534, P = 0.003). CONCLUSION Liver and spleen stiffness increase after a major liver resection for hepatic tumors in patients without chronic liver disease.

关键词： Chemotherapy Adjuvant Colorectal neoplasms Elasticity imaging techniques Hepatectomy Liver neoplasms

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