Comparing Analysis Of MELD、CLD And Child-Pugh Scores For Pre-operation Risk Evaluation In Patients With Hepatocellular Carcinoma

Objective Hepatocellular carcinoma (HCC) is one of the most common malignancies worldwide, with a particularly high incidence in Chinese population. Preoperative evaluation of hepatic function is a key point for safe liver surgery. Currently, there are several criterions for assessment of liver function pre-operatively:including Child-Pugh score、MELD score、hepatic volume measurement an imaging technique of ASGPR(the full name?) and15min. retention of indo-cyanine green(ICG R15). However, no one of all the methods mentioned above is complete and sufficient for estimating liver function. In this study, Child-Pugh score, as a golden standard, was compared with other2methods, MELD score and CLD score, to assess liver function preoperatively and search a better criterion for Chinese patients with chronic liver disease and liver cancer.Methods From January2011to December2011,43patients with HCC undergone hepatectomy were enrolled in this study. Before liver resection, ICG R15and effective hepatic blood flow (EHBF) were measured, meanwhile liver function, including total bilirubin (TBIL). ALB、PT、INR、PLT and Creatinine, were monitored preoperatively and on the1st,3rd and5th postoperative day. All data were analyzed by Child-Pugh, MELD and CLD scores.Results:The mean values of liver function evaluation by Child-Pugh, MELD and CLD scores were5.302±0.513,11.186±0.394and0.588±0.513respectively in43patients. Liver failure (LF) occurred in3cases of the patients. According to CLD score, there were38cases whose score was less than1without LF, and5cases great than1, of whom3had LF, which was significantly correlated to Child-Pugh score (r=0.564P<0.01), but not to MELD score (r=0.068P>0.05).Conclusions:It is suggested from our study that as a preoperative evaluation criterion for patients with chronic liver diseases, CLD might be a good one for patients undergoing a hepatectomy and when it is combined with Child-Pugh score to assess the preoperative risk, the better evaluation will be gained.