Functional assessment of liver for extended hepatic resection in patients with obstructive jaundice
Autor: | Seiki Tashiro, Shiro Yogita, Hidenori Miyake, Masamitsu Harada, Masashi Ishikawa, You Fukuda, Keiko Yagi |
---|---|
Rok vydání: | 1997 |
Předmět: |
medicine.medical_specialty
genetic structures Hepatology business.industry Jaundice Gastroenterology eye diseases Excretion chemistry.chemical_compound chemistry Internal medicine medicine Surgery Obstructive jaundice In patient medicine.symptom Biliary decompression business Indocyanine green Abdominal surgery |
Zdroj: | Journal of Hepato-Biliary-Pancreatic Surgery. 4:263-268 |
ISSN: | 1436-0691 0944-1166 |
DOI: | 10.1007/bf02489023 |
Popis: | We studied whether the maximal excretion rate of indocyanine green (ICG Bmax) and the 2-h ICG excretion rate in the bile could be used to estimate the separate functions of the left and right liver in 20 patients with biliary obstruction at the hepatic hilus. ICG Bmax was measured after biliary decompression. An operative procedure that preserved the side of the liver with a positive ICG Bmax value was selected. Eighteen patients tolerated extensive hepatic resection, such as right trisegmentectomy, extended right lobectomy, extended left lobectomy, or left lobectomy. However, prolonged jaundice was observed postoperatively in five of the six patients with 2-h excretion rates of less than 25% and who had undergone extended right lobectomy. One patient on whom extended right lobectomy had been performed died because of postoperative hepatic failure. His ICG Bmax value was +0.6 and his 2-h excretion rate was very low (3%). ICG Bmax and the 2-h excretion rate in the bile reflected well the degree of separate hepatic dysfunction in patients with biliary obstruction at the hepatic confluence. If ICG Bmax value is more than +1.0, resection of more than two segments, such as trisegmentectomy or extended hepatic lobectomy, may be tolerated, and if the ICG Bmax value is positive, hepatic lobectomy may be tolerated. ICG Bmax and 2-h excretion rate in bile are useful indicators of hepatic functional reserve of the separate lobes of the liver in patients with biliary obstruction at the hepatic hilus. |
Databáze: | OpenAIRE |
Externí odkaz: |