Detailed Abstract
[Liver Poster Presentation 3 - Liver (Liver Disease/Surgery)]
[LV PP 3-3] Liver Remnant (FLR)assessment After Major Hepatectomies With Liver Volumetry Using Ct And Functionality Evaluation With Single Photon Emission (SPECT)computed Tomography-hepatobiliary Scintigraphy(HBS
Mikel PRIETO*1 , Mikel GASTACA1 , Arkaitz PERFECTO1 , Patricia RUIZ1 , Pablo MÍNGUEZ1 , Ibone PALOMARES1 , Alberto VENTOSO1 , Sara MAMBRILLA1 , Emilia RODEÑO1 , Andrés VALDIVIESO1
1 Hepatobiliary And Liver Transplant Unit, Cruces University Hospital, SPAIN
Background : HBS is used as a method to evaluate liver function. SPECT has allowed a more accurate measurement of it.
Methods : Prospectively, Since 2017, we perform a CT volumetry and SPECT-HBS in all mayor liver resections excluding left hepatectomy with non-compromised FLR. The SPECT-HBS will assess FLR function(FLR-F) with FLR%, De Graaf (< 2.7% / min / m2 ) and HIBA-Index(15%) (below those index it could be related to higher rates of liver failure, LF). LF is measured by IGSLS.
Results : A total of 56 patients were included, 6 of them being excluded preoperatively (progression).Cholangiocarcinoma was the most common diagnosis (58%). 56% were female with a median age of 71 years. 20% had portal vein embolization. In 14% ALPPS was performed. The median FLR and FLR% were 632g and 44% . The median FLR-F% was 43% , median FRL-F and HIBA index were 2.78%/min/m2 and 22.5%. 59.5% had a De Graaf and 32.6% a HIBA-index below the cutoff values . 22% had postoperative morbidity, 4% were ≥ IIIb. Those two patients (4%) that showed post-resection liver failure had De Graaf below the cutoff value (2.2%/min/m2 ) but HIBA-index(17%-26%) above it, both associated to postoperative portal thrombosis.
Conclusions : Patients with a De Graaf index <2.7 %/min/m2 and a HIBA index <15% did not develop LF in our study . The two LF had a direct relationship with technical postoperative portal thrombosis. The current cut-off of FLR-F measured with De Graaf and HIBA index did not estimate the risk of postoperative LF in our study.
Methods : Prospectively, Since 2017, we perform a CT volumetry and SPECT-HBS in all mayor liver resections excluding left hepatectomy with non-compromised FLR. The SPECT-HBS will assess FLR function(FLR-F) with FLR%, De Graaf (< 2.7% / min / m2 ) and HIBA-Index(15%) (below those index it could be related to higher rates of liver failure, LF). LF is measured by IGSLS.
Results : A total of 56 patients were included, 6 of them being excluded preoperatively (progression).Cholangiocarcinoma was the most common diagnosis (58%). 56% were female with a median age of 71 years. 20% had portal vein embolization. In 14% ALPPS was performed. The median FLR and FLR% were 632g and 44% . The median FLR-F% was 43% , median FRL-F and HIBA index were 2.78%/min/m2 and 22.5%. 59.5% had a De Graaf and 32.6% a HIBA-index below the cutoff values . 22% had postoperative morbidity, 4% were ≥ IIIb. Those two patients (4%) that showed post-resection liver failure had De Graaf below the cutoff value (2.2%/min/m2 ) but HIBA-index(17%-26%) above it, both associated to postoperative portal thrombosis.
Conclusions : Patients with a De Graaf index <2.7 %/min/m2 and a HIBA index <15% did not develop LF in our study . The two LF had a direct relationship with technical postoperative portal thrombosis. The current cut-off of FLR-F measured with De Graaf and HIBA index did not estimate the risk of postoperative LF in our study.
SESSION
Liver Poster Presentation 3
Poster Presentation 3/24/2023 2:50 PM - 3:50 PM