J.Jpn. Surg. Soc.. 82(8): 885-897, 1981

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Original article

RESECTABILITY AND HEPATIC FUNCTIONAL RESERVE IN LIVER SURGERY

This paper focuses on determintion of the resectability of the liver and the postoperative hepatic functions reserve. For this aim, an improved method of ICG maximal removal rate (ICG Rmax) was established to obtain ICG Rmax within a short time from the kinetic analysis of ICG plasma disappearance curves.
Fifty six cases consisting of 29 surgical patients without hepatectomy and 27 hepatectomized cases were examined with this index on the 3rd, 7th, 14th, and 28th postoperative days.
The curve of this index showed a typical drop on the 3rd postoperative day and a gradual return until the 28th day. This drop differed depending upon the disease and the method of hepatectomy, i.e. less in gastrectomy and highest in right-extended hepatectomy.
In the follow-up study, the cases who showed a drop under 0.1mg/kg/min. were stormy postoperatively followed by death of liver failure. The rates of the drop as compared with the preoperative value of this index differed as to the method of hepatectomy, i.e., 27.3±25.9% in 1-hepatic lobectomy, 69.6±7.2% in r-hepatic lobectomy and 85.7±7.0% in extended lobectomy.
Summarizing the above-mentioned results, the indispensable minimum value for operation was calculated as being 0.4mg/kg/min. in r-hepatic lobectomy.

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