J.Jpn. Surg. Soc.. 83(11): 1307-1320, 1982
Original article
ICG CONCENTRATION IN THE BILE-AS INDICATOR FOR QUANTITATIVE ASSESSMENT OF THE EFFECT OF BILIARY DECOMPRESSION IN PATIENTS WITH OBSTRUCTIVE JAUNDICE
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Second Department of Surgery, Nagasaki University, School of Medicine, Nagasaki, Japan (Director : Prof. Ryoichi Tsuchiya) Susumu Oka |
ICG maximal excretion rate in the bile as a function of time (ICG Bmax) was caluculated by the following equation : ICG Bmax=loge { loge (10x peak concentration) peak concentration time } In 16 non-jaundiced patients, the mean peak concentration of ICG in the bile and the peak concentration time were 20±9.2mg/dl and 1.9±0.4 hours, respectively. ICG Bmax showed, in all the cases, above 0.5 with an average of 1.06±0.27. Of 26 patients with obstructive jaundice, 17 patients in whom ICG Bmax immediately after biliary decompression had remained above -0.5 well tolerated further operations, whereas 6 of the remaining 9 patients in whom ICG Bmax had not improved more than -0.5 even after decompression resulted in severe postoperative complications or in death due to hepatic failure. ICG Bmax in patients with prolonged jaundice or with additional cholangitis showed delayed or even more decreased response to biliary decompression. These results clearly indicated that ICG Bmax was a reliable assessment of hepatic functional reserve in jaundiced patient after biliary decompression prior to further surgical interventions.
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