The Value Of The Liver Reserve Function Estimation Combined With Child-pugh Score、Indocyanine Green Clearance (ICG) Test And Remnant Liver Volume Estimation In Hepatectomy

Objective : To discuss the clinical application value of liver reserve function estimation combined with Child-Pugh score 、Indocyanine Green Clearance(ICG)test and remnant liver volume estimation in the hepatic carcinoma resection accompanied by liver cirrhosis.Methods: 204 primary hepatocellular carcinoma cases with liver cirrhosis,receiving operation during 2014.10.1-2016.10.1,were chosen randomly to undergo liver resection for the first time.Then the data based on preoperative liver function,as well as postoperative hepatic function,Child-Pugh score,ICG test,remnant liver volume estimation were analyzed retrospectively.Results: Cases were grouped into group A and group B according to the postoperative liver function recovery.There were no significant differences in preoperative ALT、AST、 TB、 ALB、r-GGT(P=0.86、0.83、0.94、0.183、0.07),but in PT(P=0.03)and ALP(P=0.01)、 ICG R15 test(P<0.05),as well as remnant liver volume estimation(P<0.05)。Logistic regression test showed that both ICG R15(P<0.05)test and remnant liver volume estimation(P=0.03)were predictors of postoperative hepatic decompensation.According to linear correlation test,ICG R15 test and remnant liver volume estimation were mutual independent(P=0.41>0.05),whereare PT(r=0.28,P=0.01)and ALP(r=0.26,P=0.02)were correlated with ICG R15 test.Conclusions: For patients with primary hepatocellular carcinoma and liver cirrhosis,the estimation of hepatic reserve function by uniting Child-Pugh score 、Indocyanine Green Clearance test and remnant liver volume estimation is more accurate and more helpful than just by one way,which does favor for making surgical plans.