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KMID : 0384119870070010019
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Korean Journal of Clinical Pathology
1987 Volume.7 No. 1 p.19 ~ p.26
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Determination of ICG-Rmax in Hepatocellular Carcinoma and Liver Cirrhosis
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김완/Kim, Wan
정화순/최태열/김춘원/Chung, Wha Soon/Choi, Tae Yeal/Kim, Chun Won
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Abstract
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Advances in understanding hepatic physiology, improvement of blood banking sy￢stem and anesthesia have made extensive hepatic resections practical.
But preoperative evaluation of patients for major hepatic resection should attempt to determine resectability of the lesion as well as to evaluate the patient´s ability to withstand surgery.
Any major routine liver function tests (direct and indirect bilirubin, serum albumin, alkaline phosphatase, transaminases and prothrombin time) aids in evaluating diffuse liver diseases and/or cirrhosis but. does not determine hepatic reserve. Indocyanine green test as clearance test has been extensively investigated and is proved the most reliable index for quantitative measurement of hepatic reserve.
Present study was undertaken to determine resectability for hepatocellular carcino￢ma and/or liver cirrhosis and to compare the maximal removal rate of indocyanine green (ICG-Rmax) with other liver function
The results are as follows:
1. 4 patients among 11 patients (36. 4%) were considered to withstand hepatic lobe￢ctomy (ICG-Rmax>-0.8).
2. The mean value of ICG-Rmax in 11 patients was 0.93mg/kg/min (range: 0.34￢3.0mg/kg/min), and was significantly lower than normal values.
3. The correlations between the ICG-Rmax and the disappearance rate in low and high dose method (KICCO.5mg/kg. KICC5mg/kg) were good (r=0.89 and 0. 96 respecti￢vely).
4. The correlation between the ICG-Rmax and the serum albumin was good stati￢stically (r-0.74, p-value = 0.01) .
5. The correlation coefficiency (r) between the ICG-Rmax and total bilirubin was -0.55 but was meaningless statistically (p-value = 0. 08). 6. There is no correlation between the ICG-Rmax and PT, ALP and GPT.
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