Significance of intraoperative measurement of liver consistency prior to hepatic resection.
The functional reserve of the liver should be estimated prior to hepatectomy. While the experienced liver surgeon often relies on the findings of manual palpation intra-operatively, this approach remains a subjective one. In 22 of our patients scheduled for hepatectomy, we measured intra-operatively hepatic consistency as well as the parameters of liver function. Hepatic consistency is augmented during progression from non-fibrosis to cirrhosis. We found a statistically significant correlation between liver consistency and the indocyanine green retention rate at 15 minutes (r = 0.682; p = 0.0009) and portal vein pressure (r = 0.733; p = 0.0008). Prothrombin time, the hepaplastin test, total bilirubin and glutamic pyruvic transaminase showed no significant correlation with hepatic consistency. The safety limits of the hepatic blood circulation for the performance of hepatectomy can be estimated using parameters of consistency in this organ.
Nishizaki
T
T
Second Department of Surgery, Faculty of Medicine, Kyushu University, Fukuoka, Japan.
Matsumata
T
T
Kamakura
T
T
Adachi
E
E
Sugimachi
K
K
D006528:Carcinoma, Hepatocellular / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery; D006498:Hepatectomy; D006801:Humans; D007208:Indocyanine Green; D007430:Intraoperative Care; D008099:Liver / Q000473:pathology* / Q000503:physiopathology; D008102:Liver Circulation / Q000502:physiology; D008103:Liver Cirrhosis / Q000150:complications / Q000473:pathology*; D008111:Liver Function Tests; D008113:Liver Neoplasms / Q000150:complications / Q000175:diagnosis / Q000473:pathology* / Q000601:surgery
D007208:Indocyanine Green