Optimized liver resection range and perioperative safety in patients with high levels of indocyanine green R15

• 作者: Ang Li Meng-Jiao Liao Qian Lu Rui Tang Wen-Ping Zhao Xin-Jing Zhang
• 来源期刊: 国际肝胆胰疾病杂志(英文版)
• 年，卷（期）: 2020,（5）
• 页码范围: 495-498
• 页数: 4页
• 语种: 英文

摘要

To the Editor: The indocyanine green (ICG) clearance test is an objective mea- surement of functional liver reserve (FLR) [1] . The liver can pre- serve normal functions with a 70％ ? 80％ functional liver volume resection [2] and the remnant is capable of regeneration. How- ever, liver regenerative properties are affected by hepatitis, fatty liver, cirrhosis and damage caused by chemotherapy [3] . ICG com- bined with the Child-Pugh score are main criteria for evaluating FLR. A safe hepatectomy procedure requires the remnant liver to be 25％ ? 30％ of the normal volume. For patients with an indo- cyanine green retention rate at 15 min (ICG-R15) > 20％, segment liver resection, limited hepatectomy or tumor enucleation is rec- ommended, but there has been no clear clarification of the essen- tial remnant liver volume [4] . In China, the experts' consensus of preoperative evaluation of liver reserve function incorporates ICG- R15 tests. R SE [essential functional liver volume (EFLV)/standard liver volume (SLV)] is introduced to evaluate the safety of hep- atectomy [5] . For patients with ICG-R15 levels between 20％ and 30％, R SE = 80％ and those with an ICG-R15 level range of 30％ ? 40％ or > 40％, safe surgeries like limited hepatectomy and tumorec- tomy are recommended [6] . There is a paucity of studies that focus on surgical safety for patients with an ICG-R15 > 20％. Herein we aimed to evaluate safe liver resections in these patients.