J.Jpn. Surg. Soc.. 86(9): 1220-1222, 1985

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Report on the annual meeting

PREOPERATIVE ASSESSMENT OF HEPATOCELLULAR RESERVE BY DISCRIMINANT ANALYSIS FOR LIMITED HEPATIC RESECTION IN CIRRHOTIC PATIENTS WITH PRIMARY LIVER CANCER

We analysed various preoperative data of 32 cirrhotic patients with primary liver cancer to predict clinical course after limited hepatic resection. Out of 32 patients, postoperative course was uneventful in 26, however, the remaining 6 developed hepatic failure which led to death. The analysis of the preoperative data including liver function tests and age of patients to discriminate the two groups was carried out. It was shown that indocyanin green (ICG) test, prothrombin time (PT), lecithin cholesterol asyltransferase (LCAT),γ-globulin, age of patients and total bilirubin appeared to be important factors to discriminate the subjected patients into two groups. An equation for prediction of hepatic failure after hepatectomy obtained in this study was :
Y＝0.086726×ICG (％)
－0.054694×PT (％)
+0.102850×LCAT (μg/ml/h)
+0.059758×γ-globulin (％)
+0.077260×age
+1.099958×total bilirubin (mg/dl)
－6.776657
When Y was over 0.5, patients are considered to be at high risk for postoperative liver failure, and satisfactory postoperative course could be expected when Y was less than 0.5. This equation can be used to determine operative indication for minimal hepatic resection in cirrhotic patients with impaired liver function.

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