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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Indocyanine Green Retention Rates at 15 min Predicted Hepatic Decompensation in a Western Population
World Journal of Surgery, Volume 42, No. 8, Year 2018
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Description
Background: ICGR15 is widely used in Asia to evaluate the liver reserve before hepatectomy, but not in Western countries where patients are selected using the MELD score and/or platelet count. Postoperative liver failure is rare nowadays, but hepatic decompensation (HD), defined by 3-month postoperative ascites, impairs quality of life and survival. The aim of this study was to evaluate the relevance of indocyanine green retention rate at 15 min (ICGR15) before liver resection in Western countries, in order to predict HD. Methods: This prospectively designed study included consecutive adult patients undergoing hepatectomy for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) in three French HPB centres. Results: Between 2012 and 2014, 147 patients were included (80% of HCC and 20% of ICC). The Child–Pugh status was grade A for all patients. In the overall population and in F3/F4 patients (n = 83), ICGR15 (P = 0.02) and platelet counts (P = 0.02) were predictive of HD under multivariate analysis. Among F3/F4 patients undergoing minor hepatectomy with preoperative ICGR15 > 15%, the rate of HD was 36%. In the overall population, ICGR15 was predictive of HD (P = 0.02) and postoperative ascites (P = 0.03). The ROC curve identified a cut-off point of 15% as being associated with increased HD, with good accuracy for ICGR15 in the study population (AUROC 0.73), mainly before minor hepatectomy (AUROC 0.79). Conclusions: In patients with HCC and ICC selected using the MELD score and platelet rate, an ICGR15 > 15% is a relevant, non-invasive and clearly accurate method to predict HD specially before minor hepatectomy. © 2018, Société Internationale de Chirurgie.
Authors & Co-Authors
Grègoire, Émilie
France, Marseille
Hopital de la Conception
Serji, Badr
France, Villejuif
Hopital Paul-brousse
Golse, Nicolas
France, Villejuif
Hopital Paul-brousse
France, Lyon
Hopital de la Croix-rousse
Adam, Reńe A.
France, Villejuif
Hopital Paul-brousse
Cherqui, Daniel
France, Villejuif
Hopital Paul-brousse
Mabrut, Jean Yves
France, Lyon
Hopital de la Croix-rousse
Le-Treut, Yves Patrice
France, Marseille
Hopital de la Conception
Vi̇Bert, Éric
France, Villejuif
Hopital Paul-brousse
Statistics
Citations: 13
Authors: 8
Affiliations: 4
Identifiers
Doi:
10.1007/s00268-018-4464-6
ISSN:
03642313
Research Areas
Cancer
Disability
Maternal And Child Health
Study Design
Cross Sectional Study