[Value of postoperative indocyanine green retention rate at 15 minutes combined with standard remnant liver volume in predicting liver dysfunction after hepatectomy].

To investigate the value of indocyanine green retention rate at 15 minutes (ICG R15) on postoperative day 3 combined with standard remnant liver volume (SRLV) in predicting the occurrence of liver dysfunction after hepatectomyin hepatocellular carcinoma (HCC).
 Methods: The clinical data of 61 HCC patients undergone hepatectomy in Xiangya Hospital of Central South University from January 2015 to February 2016 were collected and analyzed. The patients were divided into 2 groups: a normal liver function group (n=40) and a liver dysfunction group (n=21). Univariate analysis was used to evaluate the risk factors for postoperative liver dysfunction. Logistic regression was used to assess the independent risk factors for postoperative liver dysfunction, and the regression equation between independent risk factors and postoperative liver dysfunction was established. The receiver operating characteristic (ROC) curve was used to examine the regression equation and compare the value difference in predicting postoperative liver dysfunction between single and combined independent risk factors.
 Results: Postoperative liver dysfunction occurred in 21 of the 61 patients, with an incidence rate at 34.4%. There was no significant difference in the time of operation, time of hepatic portal occlusion, volume of tumor and volume of resected liver between the 2 groups (all P>0.05), but there were significant differences in the ICG R15 on postoperative day 3, intraoperative blood loss and SRLV between the 2 groups (all P<0.05). The ICG R15 on postoperative day 3, intraoperative blood loss, SRLV were the risk factors for postoperative liver dysfunction. Logistic regression analysis showed ICG R15 on postoperative day 3 and SRLV were the independent risk factors for postoperative liver dysfunction, and the regression equation between independent risk factors and postoperative liver dysfunction was as follows: logit(P)=1.277+0.140×ICG R15 on postoperative day 3-5.125×SRLV. The area under the ROC curve of ICG R15 on postoperative day 3 combined with SRLV was more than that of single ICG R15 and single SRLV.
 Conclusion: ICG R15 on postoperative day 3 and SRLV are the independent risk factors for postoperative liver dysfunction. The regression equation, which is established by combination of ICG R15 with SRLV, can predict the occurrence of postoperative liver dysfunction. The accuracy of ICG R15 on postoperative day 3 combined with SRLV is better than that of single ICG R15 or single SRLV.