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Open Access 01-02-2010 | Original Article

Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

Authors: Wilmar de Graaf, Krijn P. van Lienden, Sander Dinant, Joris J. T. H. Roelofs, Olivier R. C. Busch, Dirk J. Gouma, Roelof J. Bennink, Thomas M. van Gulik

Published in: Journal of Gastrointestinal Surgery | Issue 2/2010

Abstract

Background

^99mTc-mebrofenin hepatobiliary scintigraphy (HBS) was used as a quantitative method to evaluate liver function. The aim of this study was to compare future remnant liver function assessed by ^99mTc-mebrofenin hepatobiliary scintigraphy with future remnant liver volume in the prediction of liver failure after major liver resection.

Methods

Computed tomography (CT) volumetry and ^99mTc-mebrofenin hepatobiliary scintigraphy were performed prior to major resection in 55 high-risk patients, including 30 patients with parenchymal liver disease. Liver volume was expressed as percentage of total liver volume or as standardized future remnant liver volume. Receiver operating characteristic (ROC) curve analysis was performed to identify a cutoff value for future remnant liver function in predicting postoperative liver failure.

Results

Postoperative liver failure occurred in nine patients. A liver function cutoff value of 2.69%/min/m² was calculated by ROC curve analysis. ^99mTc-mebrofenin hepatobiliary scintigraphy demonstrated better sensitivity, specificity, and positive and negative predictive value compared to future remnant liver volume. Using ^99mTc-mebrofenin hepatobiliary scintigraphy, one cutoff value suffices in both compromised and noncompromised patients.

Conclusion

Preoperative ^99mTc-mebrofenin hepatobiliary scintigraphy is a valuable technique to estimate the risk of postoperative liver failure. Especially in patients with uncertain quality of the liver parenchyma, ^99mTc-mebrofenin HBS proved of more value than CT volumetry.

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Title: Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection
Authors: Wilmar de Graaf
Krijn P. van Lienden
Sander Dinant
Joris J. T. H. Roelofs
Olivier R. C. Busch
Dirk J. Gouma
Roelof J. Bennink
Thomas M. van Gulik
Publication date: 01-02-2010
Publisher: Springer-Verlag
Published in: Journal of Gastrointestinal Surgery / Issue 2/2010
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-009-1085-2

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

Abstract

Background

Methods

Results

Conclusion

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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