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01-08-2018 | Original Scientific Report

Indocyanine Green Retention Rates at 15 min Predicted Hepatic Decompensation in a Western Population

Authors: Bertrand Le Roy, Emilie Grégoire, Cyril Cossé, Badr Serji, Nicolas Golse, René Adam, Daniel Cherqui, Jean-Yves Mabrut, Yves-Patrice Le Treut, Eric Vibert

Published in: World Journal of Surgery | Issue 8/2018

Abstract

Background

ICGR15 is widely used in Asia to evaluate the liver reserve before hepatectomy, but not in Western countries where patients are selected using the MELD score and/or platelet count. Postoperative liver failure is rare nowadays, but hepatic decompensation (HD), defined by 3-month postoperative ascites, impairs quality of life and survival. The aim of this study was to evaluate the relevance of indocyanine green retention rate at 15 min (ICGR15) before liver resection in Western countries, in order to predict HD.

Methods

This prospectively designed study included consecutive adult patients undergoing hepatectomy for hepatocellular carcinoma (HCC) and intrahepatic cholangiocarcinoma (ICC) in three French HPB centres.

Results

Between 2012 and 2014, 147 patients were included (80% of HCC and 20% of ICC). The Child–Pugh status was grade A for all patients. In the overall population and in F3/F4 patients (n = 83), ICGR15 (P = 0.02) and platelet counts (P = 0.02) were predictive of HD under multivariate analysis. Among F3/F4 patients undergoing minor hepatectomy with preoperative ICGR15 > 15%, the rate of HD was 36%. In the overall population, ICGR15 was predictive of HD (P = 0.02) and postoperative ascites (P = 0.03). The ROC curve identified a cut-off point of 15% as being associated with increased HD, with good accuracy for ICGR15 in the study population (AUROC 0.73), mainly before minor hepatectomy (AUROC 0.79).

Conclusions

In patients with HCC and ICC selected using the MELD score and platelet rate, an ICGR15 > 15% is a relevant, non-invasive and clearly accurate method to predict HD specially before minor hepatectomy.

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Title: Indocyanine Green Retention Rates at 15 min Predicted Hepatic Decompensation in a Western Population
Authors: Bertrand Le Roy
Emilie Grégoire
Cyril Cossé
Badr Serji
Nicolas Golse
René Adam
Daniel Cherqui
Jean-Yves Mabrut
Yves-Patrice Le Treut
Eric Vibert
Publication date: 01-08-2018
Publisher: Springer International Publishing
Published in: World Journal of Surgery / Issue 8/2018
Print ISSN: 0364-2313
Electronic ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-018-4464-6

ACC 2024 Congress

Springer Medicine

Indocyanine Green Retention Rates at 15 min Predicted Hepatic Decompensation in a Western Population

Abstract

Background

Methods

Results

Conclusions

ACC 2024 Congress

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

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