title: Usefulness of measuring hepatic functional volume using technetium-99m galactosyl serum albumin scintigraphy in hilar bile duct carcinoma.
abstract: This case involved a 75-year-old woman with obstructive jaundice who was diagnosed with hilar bile duct carcinoma. After endoscopic retrograde biliary drainage, the total bilirubin level was normalized. The indocyanine green test retention rate at 15 min (ICGR15) was 26%. The liver uptake ratio (LHL15) by technetium-99m galactosyl human serum albumin ((99m)Tc-GSA) liver scintigraphy was 0.87. Left hepatectomy was scheduled by CT volumetry. However, biliary drainage was insufficient, and the functional liver volume showed functional deterioration of the left liver. After percutaneous transhepatic biliary drainage, future remnant liver volume by (99m)Tc-GSA liver scintigraphy changed to 52% from 42%, and ICGR15 and LHL15 were improved to 16% and 0.914, respectively. Scheduled left hepatectomy was performed following the results of functional liver volume. The measurement of functional volume by (99m)Tc-GSA liver scintigraphy provides useful information with respect to segmental liver function for deciding operative indications.
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan. a-nanasm@net.nagasaki-u.ac.jp.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Syuuichi
authors.initials: S
authors.lastname: Tobinaga
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.affiliation: Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakamoto
authors.affiliation: Department of Radiology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Hayashi
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.affiliation: Division of Surgical Oncology, Department of Translational Medical Sciences, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8501, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
keywords: Bile duct carcinoma; Biliary obstruction; Functional liver volume; Operative indication; Technetium-99m galactosyl human serum albumin liver scintigraphy