The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG)
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RESEARCH ARTICLE
The technique of 3D reconstruction combining with biochemistry to build an equivalent formula of indocyanine green (ICG) clearance test to assess the liver reserve function Jinli Zheng1†, Wei Xie2†, Yang Huang1, Yunfeng Zhu1 and Li Jiang1*
Abstract Background: The indocyanine green (ICG) clearance test is the main method of evaluating the liver reserve function before hepatectomy. However, some patients may be allergic to ICG or the equipment of ICG clearance test was lack, leading to be difficult to evaluate liver reserve function. We aim to find an alternative tool to assist the clinicians to evaluate the liver reserve function for those who were allergic to the ICG or lack of equipment before hepatectomy. Methods: We retrospected 300 patients to investigate the risk factors affecting the liver reserve function and to build an equivalent formula to predict ICG 15 min retention rate (ICG-R15) value. Results: We found that the independent risk factors affecting ICG clearance test were total bilirubin, albumin, and spleen-to-non-neoplastic liver volume ratio (SNLR). The equivalent formula of the serological index combining with SNLR was: ICG-R15 = 0.36 × TB (umol/L) − 0.78 × ALB(g/L) + 7.783 × SNLR + 0.794 × PT (s) − 0.016 × PLT(/109) − 0.039 × ALT (IU/L) + 0.043 × AST (IU/L) + 23.846. The equivalent formula of serum index was: ICGR152 = 24.665 + 0.382 × TB (umol/L) − 0.799 × ALB(g/L) − 0.025 × PLT(/109) + 0.048 × AST(IU/L) − 0.045 × ALT(IU/L). And the area under the ROC curve (AUC) of predicting ICG-R15 ≥ 10% was 0.861 and 0.857, respectively. Conclusion: We found that SNLR was an independent risk factor affecting liver reserve function. Combining with SNLR to evaluate the liver reserve function was better than just basing on serology. Keywords: Hepatectomy, Liver reserve function, ICG clearance test, ICG 15 min retention rate Background Hepatectomy is still as the first-line treatment for the patients with hepatic nodules, especially for hepatocellular carcinoma [1–3]. Though the liver transplantation *Correspondence: [email protected] † Jinli Zheng and Wei Xie contributed equally to this study and are co-first authors 1 Department of Liver Surgery, Liver Transplantation Center, West China Hospital of Sichuan University, Chengdu, Sichuan, China Full list of author information is available at the end of the article
is the optimal treatment for the early stage hepatocellular carcinoma [4], the lack of organs limits its feasibility. With the development of surgical techniques and preoperative managements, the postoperatvie complications have drown from 20% to 3–5% [5–7]. Nowadays, the posthepatectomy liver failure (PHLF) is the main reason of the perioperative death, which is mainly caused by the insufficient residual liver function [8, 9]. Therefore, it is still necessary to evaluate the liver reserve function before hepatectomy.
© The Author(s) 2020. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptatio
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