Preoperative estimation of risk in hepatectomy using technetium-99m-galactosyl human serum albumin receptor amount by nonlinear 3-compartment model.
OBJECTIVE
Recently, we developed the method for measurement of the technetium-99m-diethylenetriamine-pentaacetic acid-galactosyl human serum albumin (Tc-GSA) receptor amount (R0) using a nonlinear 3-compartment model. We examined the usefulness of R0 for preoperative estimation of risk in hepatectomy.


METHODS
Sixty-three patients who underwent hepatectomy in our hospital were examined for R0. These patients consisted of 26 cases of normal liver, 16 cases of liver fibrosis, and 21 cases of cirrhosis. R0 was measured by the nonlinear 3-compartment model of ligand-receptor binding without blood sampling in Tc-GSA scintigraphy. The expected remnant liver R0 after hepatectomy was calculated from CT volumetry before hepatectomy.


RESULTS
The preoperative mean R0 of liver was 15.8 +/- 3.8 mg for Z0, 13.8 +/- 3.9 mg for Z1, and 6.9 +/- 2.3 mg for Z2. R0 in Z2 was significantly lower than Z0 and Z1 (p < 0.0001). Every patient whose remnant liver R0 was over 5 mg tolerated hepatectomy without any postoperative complications. Among 63 cases, 5 patients developed postoperative complications (two liver failures, two postoperative jaundice and one hepatic coma), and remnant liver R0 of these patients were under 5 mg.


CONCLUSIONS
From these results, it can be seen that R0 of remnant liver is a useful parameter to decide indication of hepatectomy and predict postoperative complications.
Katsuramaki
Tadashi
T
Department of Surgery (Section 1), Sapporo Medical University, School of Medicine, South-1, West-16, Chuo-ku, Sapporo, 060-8543, Japan. katsuram@sapmed.ac.jp
Fujimori
Kenji
K
Furuhata
Tomohisa
T
Kimura
Yasutoshi
Y
Meguro
Makoto
M
Nagayama
Minoru
M
Honma
Toshio
T
Mukaiya
Mitsuhiro
M
Hareyama
Masato
M
Hirata
Koichi
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008107:Liver Diseases / Q000000981:diagnostic imaging* / Q000503:physiopathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D017711:Nonlinear Dynamics; D011183:Postoperative Complications; D011300:Preoperative Care / Q000379:methods*; D019275:Radiopharmaceuticals; D017457:Receptors, Albumin / Q000032:analysis*; D011975:Receptors, Mitogen / Q000032:analysis*; D020127:Recovery of Function / Q000502:physiology; D018570:Risk Assessment / Q000379:methods*; D013668:Technetium Tc 99m Aggregated Albumin; D016284:Technetium Tc 99m Pentetate; D014055:Tomography, Emission-Computed / Q000379:methods*
D019275:Radiopharmaceuticals; D017457:Receptors, Albumin; D011975:Receptors, Mitogen; D013668:Technetium Tc 99m Aggregated Albumin; C098258:galactosyl receptor; C070561:technetium Tc 99m DTPA-galactosyl-human serum albumin; D016284:Technetium Tc 99m Pentetate