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| Optimized liver resection range and perioperative safety in patients with high levels of indocyanine green R15 |
| Rui Tang a , Xin-Jing Zhang a , Meng-Jiao Liao a , b , Ang Li a , Wen-Ping Zhao a , Qian Lu a , ∗ |
a Hepatopancreatobiliary Center, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Institute for Precision Medicine, Tsinghua University,
Beijing 102218, China
b Department of General Surgery, the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai 519100, China
∗ Corresponding author.
E-mail address: luqian_lt@163.com (Q. Lu). |
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Abstract The indocyanine green (ICG) clearance test is an objective measurement of functional liver reserve (FLR) [1] . The liver can preserve normal functions with a 70%−80% functional liver volume resection [2] and the remnant is capable of regeneration. However, liver regenerative properties are affected by hepatitis, fatty liver, cirrhosis and damage caused by chemotherapy [3] . ICG combined with the Child-Pugh score are main criteria for evaluating FLR. A safe hepatectomy procedure requires the remnant liver to be 25%−30% of the normal volume. For patients with an indocyanine green retention rate at 15 min (ICG-R15) > 20%, segment liver resection, limited hepatectomy or tumor enucleation is recommended, but there has been no clear clarification of the essential remnant liver volume [4] . In China, the experts’ consensus of preoperative evaluation of liver reserve function incorporates ICGR15 tests. R SE [essential functional liver volume (EFLV)/standard liver volume (SLV)] is introduced to evaluate the safety of hepatectomy [5] . For patients with ICG-R15 levels between 20% and 30%, R SE = 80% and those with an ICG-R15 level range of 30%−40% or > 40%, safe surgeries like limited hepatectomy and tumorectomy are recommended [6] . There is a paucity of studies that focus on surgical safety for patients with an ICG-R15 > 20%. Herein we aimed to evaluate safe liver resections in these patients.
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2020, Vol. 19 
