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KMID : 0870420110150010001
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Korean Journal of Hepato-Biliary-Pancreatic Surgery
2011 Volume.15 No. 1 p.1 ~ p.6
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Major Hepatectomy in the HCC Patient with an Indocyanine Green Retention Rate at 15 Minutes of 10% or Higher: Predictive Values of Postoperative Hepatic Failure
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Lee Chae-Yoon
Hwang Yoon-Jin
Chun Jae-Min
Kwon Hyoung-Joon
Son Joon-Ho
Kim Sang-Geol
Yun Yung-Kook
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Abstract
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Purpose: Major hepatic resection is sometimes inevitable in patients with impaired liver function. We evaluated risk factors that cause postoperative liver failure after major hepatic resection in patients with over a 10% Indocyanine Green Retention rate at 15 minutes (ICGR15).
Methods: From Apr. 2002 to Aug. 2009, 32 patients who had over a 10% rate of ICGR15 underwent major hepatic resection (≥4 Couinaud segments). Among the 32, 9 patients showed postoperative liver failure (less than 50% prothrombine time and/or 5 mg/dl or higher of total bilirubin). This high-risk group was compared to the rest who constituted a low-risk group.
Results: Patients with esophageal varix were more common in the high risk group (4 versus 2, p=0.043). Other clinicopathologic features showed no difference between the two groups. We had 2 in-hospital deaths in the high risk group.
Conclusion: Great care is needed in patients with esophageal varix and limited liver function during major hepatic resection.
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KEYWORD
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Hepatocellular carcinoma, Hepatectomy, Hepatic failure, Esophageal varix
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