title: Hepatectomy Based on Future Liver Remnant Plasma Clearance Rate of Indocyanine Green.
abstract: Background. Hepatectomy, an important treatment modality for liver malignancies, has high perioperative morbidity and mortality rates. Safe, comprehensive criteria for selecting patients for hepatectomy are needed. Since June 2011, we have used a cut-off value of ≧ 0.05 for future liver remnant plasma clearance rate of indocyanine green as a criterion for hepatectomy. The aim of this study was to verify the validity of this criterion. Methods. From June 2011 to December 2015, 212 hepatectomies were performed in Tenri Yorozu Hospital. Of these 212 patients, 107 who underwent preoperative computed tomography imaging volumetry, indocyanine green clearance test, and hepatectomy (excluding partial resection or enucleation) were retrospectively analyzed. Results. There was no postoperative mortality. Posthepatectomy liver failure occurred in 59 patients (55.1%) (International Study Group of Liver Surgery Grade A: 43 cases (40.2%), Grade B: 16 cases (15.0%), and Grade C: no cases). Operative morbidity greater than Clavien-Dindo Grade 3 occurred in 23 patients (21.5%). A low future liver remnant plasma clearance rate of indocyanine green was a good predictor for Grade B cases (area under curve = 0.804; 95% confidence interval, 0.712-0.895). Conclusion. Liver remnant plasma clearance rate of indocyanine green is a valid criterion for hepatectomy.
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Yuichiro
authors.identifier: 0000-0002-5347-4686
authors.initials: Y
authors.lastname: Uchida
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Furuyama
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Daiki
authors.initials: D
authors.lastname: Yasukawa
authors.affiliation: Division of Hepato-Biliary-Pancreatic and Transplant Surgery, Graduate School of Medicine, Kyoto University, 54 Shogoin-kawahara-cho, Kyoto 606-8507, Japan.
authors.forename: Hiroto
authors.initials: H
authors.lastname: Nishino
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Ando
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Hata
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Machimoto
authors.affiliation: Department of Gastrointestinal and General Surgery, Tenri Yorozu Hospital, 200 Mishima-cho, Tenri, Nara 632-8552, Japan.
authors.forename: Tsunehiro
authors.initials: T
authors.lastname: Yoshimura