Gao Junping, Lu Zhan, Liang Wanqiang, Zhang Jie, Qin Shangdong, Huang Juntao, Gong Wenfeng, Xiang Bangde
Department of Hepatobiliary Surgery, Guangxi Medical University Cancer Hospital, Nanning, China.
Department of General Surgery, Wuxiang Hospital of the Third Affiliated to, Guangxi Medical University, Nanning, China.
Nutr Cancer. 2025;77(3):372-379. doi: 10.1080/01635581.2024.2431348. Epub 2024 Nov 21.
This study investigated the safe indocyanine green retention rate at the 15-minute (ICG-R15) threshold for hepatectomy and the effect of nutritional management on ICG-R15 and posthepatectomy liver failure (PHLF).
A retrospective cohort study was conducted on 70 hepatectomy patients with chronic liver disease, divided into routine care and nutrition intervention groups. ICG-R15 was measured pre- and postoperatively, along with PHLF occurrence and other health metrics.
Seventy patients with chronic liver disease were divided into two groups: one received routine care, while the other followed a nutrition plan based on Omaha theory. The intervention group showed a significantly lower incidence of PHLF (15.8% vs 41.2%, = 0.009) and clinically relevant PHLF (5.3% vs 19.6%, = 0.031), along with shorter hospital stays (11.3 ± 6.4 days vs 21.5 ± 15.5 days, = 0.012) and fewer complications (26.3% vs 47.1%, = 0.020). The optimal ICG-R15 threshold for predicting PHLF was 4.5%, with 8.5% being critical.
ICG-R15 is a reliable predictor of PHLF, with 4.5% being safe and 8.5% critical. Nutritional management based on Omaha theory improves outcomes and quality of life. Further validation is needed.
本研究调查了肝切除术15分钟时安全的吲哚菁绿滞留率（ICG-R15）阈值以及营养管理对ICG-R15和肝切除术后肝功能衰竭（PHLF）的影响。
对70例慢性肝病肝切除术患者进行回顾性队列研究，分为常规护理组和营养干预组。术前和术后测量ICG-R15，以及PHLF的发生情况和其他健康指标。
70例慢性肝病患者分为两组：一组接受常规护理，另一组遵循基于奥马哈理论的营养计划。干预组PHLF的发生率显著降低（15.8%对41.2%，P = 0.009），临床相关PHLF的发生率也显著降低（5.3%对19.6%，P = 0.031），住院时间缩短（11.3±6.4天对21.5±15.5天，P = 0.012），并发症减少（26.3%对47.1%，P = 0.020）。预测PHLF的最佳ICG-R15阈值为4.5%，临界值为8.5%。
ICG-R15是PHLF的可靠预测指标，4.5%为安全值，8.5%为临界值。基于奥马哈理论的营养管理可改善预后和生活质量。尚需进一步验证。
