title: Liver-to-spleen ratio as an index of chronic liver diseases and safety of hepatectomy: a pilot study.
abstract: BACKGROUND
  Hepatic failure is a main cause of death after hepatectomy. Accurate preoperative evaluation of functional liver reserve is the key to ensure safe resection. Studies have found that the spleen would gradually enlarge as chronic liver disease worsened. This study was designed to determine whether preoperative liver-to-spleen ratio (LSR) would be an indicator to evaluate severity of liver disease and predict safety of hepatectomy.
  
  
  METHODS
  The volumes of liver and spleen were evaluated on computed tomography scan in 67 patients who received partial hepatectomy. Preoperative LSR was calculated. Statistical analysis was conducted to examine the relationship between LSR and the degree of chronic liver disease. Ability of LSR to predict the safety of hepatectomy also was evaluated.
  
  
  RESULTS
  LSR had a negative correlation with the degree of chronic liver diseases (r = -0.606, P < 0.0001). LSR = 3.22 was the cutoff point for predicting posthepatectomy complications and inadequacy. AUC, sensitivity, and specificity for predicting posthepatectomy complications and inadequacy respectively were 0.830 (95 % confidence interval [CI] 0.715-0.950, P < 0.0001), 69.6, 93.2 %, and 0.863 (95 % CI 0.777-0.949, P < 0.0001), 68.8, 84.3 %. Multivariate analysis showed that LSR = 3.22 was the factor that affected both posthepatectomy complications and liver inadequacy.
  
  
  CONCLUSIONS
  Preoperative LSR score correlated well with the degree of chronic liver diseases, and it probably help us to improve the safety of hepatectomy.
authors.affiliation: Clinical Center of Liver Disease, Shanghai Public Health Clinical Center, 56 Shuidian Road, Shanghai, China, eric_huangyq@163.com.
authors.forename: Yangqing
authors.initials: Y
authors.lastname: Huang
authors.forename: Bin
authors.initials: B
authors.lastname: Huang
authors.forename: Tong
authors.initials: T
authors.lastname: Kan
authors.forename: Boshuai
authors.initials: B
authors.lastname: Yang
authors.forename: Min
authors.initials: M
authors.lastname: Yuan
authors.forename: Jiefei
authors.initials: J
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001663:Bilirubin / Q000097:blood; D002908:Chronic Disease; D005260:Female; D006498:Hepatectomy / Q000009:adverse effects*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology* / Q000503:physiopathology; D008107:Liver Diseases / Q000601:surgery; D017093:Liver Failure / Q000209:etiology; D008113:Liver Neoplasms / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D010865:Pilot Projects; D011237:Predictive Value of Tests; D011517:Prothrombin Time; D012720:Severity of Illness Index; D013154:Spleen / Q000000981:diagnostic imaging / Q000473:pathology*; D014057:Tomography, X-Ray Computed; D055815:Young Adult
chemical_list: D001663:Bilirubin