Analysis Of Clinical Factors Related To Future Liver Remnant Kinetic Growth Rate After ALPPS-Ⅰ Stage

Objective:To investigate the clinical factors related to the future liver remnant kinetic growth rate in patients with liver cancer after associated liver partition and portal vein ligation for staged hepatectomy(ALPPS)-I stage.Methods:The clinical data of 61 patients with liver cancer who underwent ALPPS in the First Affiliated Hospital of Guangxi Medical University from February 2017 to October 2020 were collected for statistical analysis.The IQQA liver three-dimensional imaging system of hepatobiliary surgery in the First Affiliated Hospital of Guangxi Medical University was used to calculate the remaining liver volume of the healthy side before and after the first stage of ALPPS The kinetic growth rate(KGR)of the remaining liver volume was calculated,and the related factors of KGR were analyzed by logistic regression model.Results:A total of 61 patients with HCC and cholangiocarcinoma were included in this study.The median preoperative FLR was 390ml(194ml-518ml),accounting for 36%(22%-48.34%).The median postoperative FLR increased to 557ml(378ml-823ml),accounting for 53%(34%-85%),and the median KGR was 4.54%(0.11%-37.14%),Univariate and multivariate logistic regression analysis were performed with KGR=5.04%as the baseline.ICG15R(OR=0.632(0.455-0.844)P=0.007)and liver fibrosis(OR=0.59(0.376-0.926)P=0.022)were the influencing factors of liver regeneration.Further analysis of ROC curve of ICG 15min retention rate,Ishak fibrosis and KGR showed that the critical value of ICG 15min retention rate was 3.9%(AUC:0.703,P=0.04,sensitivity:72.7%,specificity:66.7%),and Ishak critical value was 4.5(AUC:0.669,P=0.007,sensitivity:46.2%,specificity:83.3%).Conclusion:ICG 15minute retention rate and liver fibrosis are independent risk factors for liver regeneration.Preoperative evaluation of ICG 15minute retention rate and liver fibrosis may have a certain predictive effect on liver regeneration.