The Value Of Indocyanine Green Clearance Test In Primary Hepatic Carcinoma Preoperative To Assess Liver Reserve Function

Objective:Study of indocyanine green test in primary liver cancer preoperativeevaluation of liver functional reserve, guide the hepatic segment resectionrange, predictive value of postoperative liver function recovery ofcorrelation; indocyanine green test and Child-pugh score in evaluation ofliver reserve function; explore more accurate assessment of liver reservefunction.Research methods:Review of the Institute of hepatobiliary surgery of2011.06-2013.2during liver resection operation in patients with primary hepatocellularcarcinoma in45cases, preoperative application of Child-pughclassification of liver function, indocyanine green test and conventionalbiochemical tests of the liver function evaluation of liver functionalreserve. According to Child-pugh classification divided into Grade A andB; according to the preoperative ICGR15values will be divided into threegroups: group a, ICGR15≤10%,10%<ICGR15<15%group b,15%≤ICGR15<19%group c, b group c group can come to the abnormal group according to the operation; liver function recovery for compensatedliver function group, hepatic functional reserve of mild insufficiencygroup, hepatic functional reserve of severe insufficiency group, includingboth regression of liver dysfunction group. The comprehensive analysis,correlation analysis were compared in different groups of liver functionrecovery and grade of liver function and Child-pugh.Result.1The incidence of liver dysfunction in1, after the operation, a, B, Cgroups were17.6%,42.9%,50%, there was significant differencebetween the three groups. ICGR15compensated liver function group andhepatic decompensation group value after further analysis, two groups ofICGR15value had significant difference.2Preoperative ICGR15, ICGK correlation analysis and Child-pughclassification, results there was significant difference between twogroups.3According to Child-pugh class a postoperative liver function in8patients with decompensation of the further analysis of the preoperativeICGR15values, results showed that the8cases of patients with ICGR15(9.26±4.37)%and no hepatic decompensation28patients withpreoperative ICGR15value (4.15±3.03)%. The difference is statisticallysignificant. 4The evaluation index of ICGR15level and routine liver functionanalysis, namely: the correlation analysis of ICGR15and preoperativeALB, ALT, PA, TB results showed: preoperative ICGR15value wasnegatively correlated with ALB, PA, and positively correlated with TB.Preoperative ICGR15values had no significant correlation with ALT.5This paper found that the scope of operation, and the value ofICGR15and hepatic segment resection of hepatic function after recovery,further analysis shows that,28cases in the range of the whole livervolume below30%in patients with a total of2cases of hepaticinsufficiency.17patients of liver resection in more than30%of the13patients with ICGR15<10%, of which5cases of liver dysfunction,failure rate was38.5%;4cases of10%<ICGR15<19%patients all liverdysfunction, failure rate was100%. Comparing the two groups, thedifference was statistically significant.Conclusion:ICG excretion test is to evaluate the primary liver reserve function inpatients with liver resection, guidance, good prediction index of hepaticdysfunction after operation, there is a good correlation of grading andChild-pugh liver function ICGR15and ICGK measured value, is a usefulcomplement to Child-pugh classification. Preoperative ICGR15and ALB, PAwere negative correlation, positive correlation with TB.