Autoren:	Horisberger, Karoline Rössler, Fabian Oberkofler, Christian E. Raptis, Dimitri Petrowsky, Henrik Clavien, Pierre-Alain
Titel:	The value of intraoperative dynamic liver function test ICG in predicting postoperative complications in patients undergoing staged hepatectomy : a pilot study
Online-Publikationsdatum:	22-Aug-2023
Erscheinungsdatum:	2023
Sprache des Dokuments:	Englisch
Zusammenfassung/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-Sachgruppe:	610 Medizin 610 Medical sciences
Veröffentlichende Institution:	Johannes Gutenberg-Universität Mainz
Organisationseinheit:	FB 04 Medizin
Veröffentlichungsort:	Mainz
ROR:	https://ror.org/023b0x485
DOI:	http://doi.org/10.25358/openscience-9437
Version:	Published version
Publikationstyp:	Zeitschriftenaufsatz
Nutzungsrechte:	CC BY
Informationen zu den Nutzungsrechten:	https://creativecommons.org/licenses/by/4.0/
Zeitschrift:	Langenbeck's archives of surgery 408
Seitenzahl oder Artikelnummer:	264
Verlag:	Springer
Verlagsort:	Berlin u.a.
Erscheinungsdatum:	2023
ISSN:	1435-2451
DOI der Originalveröffentlichung:	10.1007/s00423-023-02983-5
Enthalten in den Sammlungen:	DFG-491381577-H