Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection.
10.14701/kjhbps.2013.17.4.143
- Author:
Hee Joon KIM
1
;
Choong Young KIM
;
Young Hoe HUR
;
Yang Seok KOH
;
Jung Chul KIM
;
Chol Kyoon CHO
;
Hyun Jong KIM
Author Information
1. Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea. ckcho@jnu.ac.kr
- Publication Type:Original Article
- Keywords:
Liver volumetry;
Future liver remnant;
Liver resection;
Liver failure
- MeSH:
Bilirubin;
Body Weight;
Humans;
Liver Failure;
Liver Transplantation;
Liver*;
Retrospective Studies;
Transplants
- From:Korean Journal of Hepato-Biliary-Pancreatic Surgery
2013;17(4):143-151
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUNDS/AIMS: The future liver remnant (FLR) is usually calculated as a ratio of the remnant liver volume (RLV) to the total functional liver volume (RLV/TFLV). In liver transplantation, it is generally accepted that the ratio of the graft volume to standard liver volume (SLV) needs to be at least 30% to 40% to fit the hepatic metabolic demands of the recipient. The aim of this study was to compare RLV/TFLV versus RLV/SLV as a predictor of postoperative liver function and liver failure. METHODS: CT volumetric measurements of RLV were obtained retrospectively in 74 patients who underwent right hemihepatectomy for a malignant tumor from January 2010 to May 2013. RLV and TFLV were obtained using CT volumetry, and SLV was calculated using Yu's formula: SLV (ml)=21.585 x body weight (kg)0.732 x height (cm)0.225. The RLV/SLV ratio was compared with the RLV/TFLV as a predictor of postoperative hepatic function. RESULTS: Postheptectomy liver failure (PHLF), morbidity, and serum total bilirubin level at postoperative day 5 (POD 5) were increased significantly in the group with the RLV/SLV < or =30% compared with the group with the RLV/SLV >30% (p=0.002, p=0.004, and p<0.001, respectively). But RLV/TFLV was not correlated with PHLF and morbidity (p=1.000 and 0.798, respectively). RLV/SLV showed a stronger correlation with serum total bilirubin level than RLV/TFLV (RLV/SLV vs. RLV/TFLV, R=0.706 vs. 0.499, R2=0.499 vs. 0.239). CONCLUSIONS: RLV/SLV was more specific than RLV/TFLV in predicting the postoperative course after right hemihepatectomy. To determine the safe limit of hepatic resection, a larger-scaled prospective study is needed.
