Authors:	Horisberger, Karoline Rössler, Fabian Oberkofler, Christian E. Raptis, Dimitri Petrowsky, Henrik Clavien, Pierre-Alain
Title:	The value of intraoperative dynamic liver function test ICG in predicting postoperative complications in patients undergoing staged hepatectomy : a pilot study
Online publication date:	22-Aug-2023
Year of first publication:	2023
Language:	english
Abstract:	Purpose To assess the predictive value of intraoperative indocyanine green (ICG) test in patients undergoing staged hepatectomy. Methods We analyzed intraoperative ICG measurements of future liver remnant (FLR), preoperative ICG, volumetry, and hepatobiliary scintigraphy in 15 patients undergoing associated liver partition and portal vein ligation for staged hepatectomy (ALPPS). Main endpoints were the correlation of intraoperative ICG values to postoperative complications (Comprehensive Complication Index (CCI®)) at discharge and 90 days after surgery, and to postoperative liver function. Results Median intraoperative R15 (ICG retention rate at 15 min) correlated significantly with CCI® at discharge (p = 0.05) and with CCI® at 90 days (p = 0.0036). Preoperative ICG, volumetry, and scintigraphy did not correlate to postoperative outcome. ROC curve analysis revealed a cutoff value of 11.4 for the intraoperative R15 to predict major complications (Clavien-Dindo ≥ III) with 100% sensitivity and 63% specificity. No patient with R15 ≤ 11 developed major complications. Conclusion This pilot study suggests that intraoperative ICG clearance determines the functional capacity of the future liver remnant more accurately than preoperative tests. This may further reduce the number of postoperative liver failures, even if it means intraoperative abortion of hepatectomy in individual cases.
DDC:	610 Medizin 610 Medical sciences
Institution:	Johannes Gutenberg-Universität Mainz
Department:	FB 04 Medizin
Place:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9437
Version:	Published version
Publication type:	Zeitschriftenaufsatz
License:	CC BY
Information on rights of use:	https://creativecommons.org/licenses/by/4.0/
Journal:	Langenbeck's archives of surgery 408
Pages or article number:	264
Publisher:	Springer
Publisher place:	Berlin u.a.
Issue date:	2023
ISSN:	1435-2451
Publisher DOI:	10.1007/s00423-023-02983-5
Appears in collections:	DFG-491381577-H