The Clinical Research Of Perioperative ICGR15 For Primary Liver Cancer Posthepatectomy Liver Failure Assessment

Objective:To investigate preoperative ICGR15 in evaluating liver reserve function and predict the role of hepatic failure after liver resection; to investigate the value of postoperative ICGR15 in as an indicator of posthepatectomy liver failure assessment and judgment.Methods:From November 2015 to march 2016,54 patients were diagnosed primary liver cancer in Affiliated Tumor Hospital of Guangxi Medical University prospectively enrolled in our study.Complete the indocyanine green clearance test in preoperative and postoperative day 5, determine the ICGR15 values.Compared analysis of relationship between different preoperative ICGR15 value group and postoperative liver failure occurs.Compared analysis of relationship between preoperative ICGR15 value group under different resected liver volume and postoperative liver failure occurs.Establish the postoperative ICGR15 threshold in the case of postoperative liver failure,and compared analysis of relationship between different postoperative ICGR15 value group and postoperative liver failure occurs.Results:According to preoperative ICGR15 values will be divided into three groups:group a,ICGR15<10%; group b,10%<ICGR15<20%;group c, ICGR15≥20%.The incidence of postoperative liver failure in the three groups were 17.1%,70.0%,66.7%,there are significant difference between the three groups.32 partial liver resection patients with postoperative liver failure occurred in 7 cases. 22 patients of half liver resection of 15 patients with ICGR15<10%, which 3 patients occurred postoperative liver failure, the incidence rate was 20%;ICGR15> 10% of patients in 7 cases,6 cases occurred postoperative liver failure,the incidence rate was 85.7%.Comparing the 2 groups, the difference was statistically significant (P<0.05). The threshold of postoperative ICGR15 was 8.9% calculated by ROC in our patients when postoperative liver failure occurs.then according to postoperative ICGR15 values divided into two groups,the incidences of postoperative liver failure in the postoperative ICGR15<8.9% and postoperative liver failure in the postoperative ICGR15> 8.9% patients were 6.1% and 66.7%. Comparing the two groups, the difference was statistically significant (P<0.001) In 32 patients with irregular partial liver resection, postoperative ICGR15<8.9% of patients have 21 cases, postoperative liver failure occurred in 1 case, the incidence rate was 4.8%; postoperative ICGR15> 8.9% of patients have 11 cases, postoperative liver failure occurred in 6 case, the incidence rate was 54.5%. However, in 22 patients with half liver resection, postoperative ICGR15<8.9% of patients have 12 cases, postoperative liver failure occurred in 1 case, the incidence rate was 8.3%; postoperative ICGR15> 8.9% of patients have 10cases, postoperative liver failure occurred in 8 case, the incidence rate was 80.0%. There are significant difference between the two groups (P<0.05).Conclusion:Preoperative ICGR15 can well evaluate the liver reserve function and predict postoperative liver failure after liver resection. With the fifth day postoperative ICGR15>8.9% as the evaluation of postoperative liver failure and judgment index is has the certain reference value.