J.Jpn. Surg. Soc.. 79(12): 1526-1534, 1978

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Original article

DEVELOPMENT OF A METHOD OF ESTIMATING POSTOPERATIVE HEPATIC FUNCTIONS UPON HEPATECTOMY BEFORE THE OPERATION

Opportunities of finding small liver cancer have much increased in accordance with development of various diagnostic methods in recent years. However, many of primary liver cancer are combined with liver cirrhosis, which makes it not always easy to conduct radical operation. That is, in consideration of radical operation it is preferable to perform hepatectomy including as large nontumorous area as possible, however, as the result it increases the danger of postoperative liver insufficiency. Meanwhile, depending on the location of tumor, even it if is a very small one sometimes it is forced to have the larger area resected due to an anatomical reason in positon. Then I developed a method of estimating postoperative liver functions upon hepatectomy before the operation. First a series of animal tests to study a relatinoship between an amount of hepatic resection and a decrease of hepatic function was carried. As the result it was known that there existed a relation of 1 : 1 between the hepatic functional remaining rate and the ICG (k), reduction rate. That is :
ICG (k) _{post op}, = ICG(k) _{pre op}, X functional remaining rate.
For the purpose of calculating a functional remaining rate "Segmental liver function test" was developed. This is to compare every liver segment function with each other by measureing an extraction rate of ICG at every liver segment upon hepatic vein catheterization.
After that a functional remaining rate can be calculated by correction with ICG extraction rate at very segment on the part to be resected and the part to be remained.

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