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术前吲哚菁绿试验预测肝门部胆管癌肝切除术后肝衰竭及术后结局。

Preoperative ICG Test to Predict Posthepatectomy Liver Failure and Postoperative Outcomes in Hilar Cholangiocarcinoma.

机构信息

Department of General Surgery, Zhongshan Hospital, Fudan University, 180, Fenglin Road, Shanghai 200032, China.

Department of Critical Care Medicine, Zhongshan Hospital, Fudan University, 180, Fenglin Road, Shanghai 200032, China.

出版信息

Biomed Res Int. 2021 Feb 23;2021:8298737. doi: 10.1155/2021/8298737. eCollection 2021.

DOI:10.1155/2021/8298737
PMID:33681380
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7925035/
Abstract

Preoperative evaluation of hepatic functional reserve in patients with hilar cholangiocarcinoma (hCCA) has vital clinical significance for prevention of posthepatectomy liver failure (PHLF) and mortality. The aim of the present study was to evaluate the clinical significance of the indocyanine green retention rate at 15 minutes (ICG R15) and related factors of postoperative outcomes in patients with hCCA. 147 patients who scheduled for hCCA resection underwent a preoperative ICG test between May 2015 and May 2020 and were prospectively analyzed. Single-factor analysis was used to evaluate the risk factors for PHLF and postoperative outcomes in hCCA. After univariate analysis, significant differences in ICG R15 were found between the PHLF group and the liver function recovered well (LFRW) group ( ≤ 0.05). In terms of postoperative complications, ICG R15 was also a risk factor for moderate-to-severe postoperative complications. Preoperative ICG R15 was significantly associated with PHLF and moderate-to-severe postoperative complications. ICG R15 may become an ideal clinical indicator for the evaluation of liver function reserve before hCCA and can better predict the postoperative complications.

摘要

术前评估肝门部胆管癌(hCCA)患者的肝储备功能对于预防肝切除术后肝功能衰竭(PHLF)和死亡率具有重要的临床意义。本研究旨在评估 15 分钟吲哚菁绿滞留率(ICG R15)及与 hCCA 术后结局相关因素的临床意义。2015 年 5 月至 2020 年 5 月,对 147 例行 hCCA 切除术的患者进行了术前 ICG 试验,并进行了前瞻性分析。单因素分析用于评估 hCCA 患者 PHLF 和术后结局的危险因素。单因素分析后,PHLF 组与肝功能恢复良好(LFRW)组的 ICG R15 差异有统计学意义(≤0.05)。就术后并发症而言,ICG R15 也是中重度术后并发症的危险因素。术前 ICG R15 与 PHLF 和中重度术后并发症显著相关。ICG R15 可能成为 hCCA 术前评估肝功能储备的理想临床指标,并能更好地预测术后并发症。