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The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection

Postoperative liver dysfunction remains a major concern following hepatic resection. In order to identify patients who are at risk of developing liver dysfunction, indocyanine green (ICG) clearance has been proposed to predict postoperative liver function. All patients who underwent liver resection...

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Autores principales: Schwarz, Christoph, Plass, Immanuel, Fitschek, Fabian, Punzengruber, Antonia, Mittlböck, Martina, Kampf, Stephanie, Asenbaum, Ulrika, Starlinger, Patrick, Stremitzer, Stefan, Bodingbauer, Martin, Kaczirek, Klaus
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Nature Publishing Group UK 2019
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Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557886/
https://www.ncbi.nlm.nih.gov/pubmed/31182746
http://dx.doi.org/10.1038/s41598-019-44815-x
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author Schwarz, Christoph
Plass, Immanuel
Fitschek, Fabian
Punzengruber, Antonia
Mittlböck, Martina
Kampf, Stephanie
Asenbaum, Ulrika
Starlinger, Patrick
Stremitzer, Stefan
Bodingbauer, Martin
Kaczirek, Klaus
author_facet Schwarz, Christoph
Plass, Immanuel
Fitschek, Fabian
Punzengruber, Antonia
Mittlböck, Martina
Kampf, Stephanie
Asenbaum, Ulrika
Starlinger, Patrick
Stremitzer, Stefan
Bodingbauer, Martin
Kaczirek, Klaus
author_sort Schwarz, Christoph
collection PubMed
description Postoperative liver dysfunction remains a major concern following hepatic resection. In order to identify patients who are at risk of developing liver dysfunction, indocyanine green (ICG) clearance has been proposed to predict postoperative liver function. All patients who underwent liver resection at the Medical University Vienna, Austria between 2006 and 2015 with preoperative ICG clearance testing (PDR, R15) were analyzed in this study. Postoperative liver dysfunction was analyzed as defined by the International Study Group of Liver Surgery. Overall, 698 patients (male: 394 (56.4%); female: 304 (43.6%)) with a mean age of 61.3 years (SD: 12.9) were included in this study, including 313 minor liver resections (44.8%) and 385 major liver resections (55.2%). One hundred and seven patients developed postoperative liver dysfunction after liver resection (15.3%). Factors associated with liver dysfunction were: male sex (p = 0.043), major liver resection (p < 0.0001), and preoperative ICG clearance (PDR (p = 0.002) and R15 (p < 0.0001)). Notably ICG clearance was significantly associated with liver dysfunction in minor and major liver resections respectively and remained a predictor upon multivariable analysis. An optimal cut-off for preoperative ICG clearance to accurately predict liver dysfunction was PDR < 19.5%/min and R15 > 5.6%. To the best of our knowledge, this is the largest study analyzing the predictive value of preoperative ICG clearance assessment in patients undergoing liver resection. ICG clearance is useful to identify patients at risk of postoperative liver dysfunction.
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spelling pubmed-65578862019-06-19 The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection Schwarz, Christoph Plass, Immanuel Fitschek, Fabian Punzengruber, Antonia Mittlböck, Martina Kampf, Stephanie Asenbaum, Ulrika Starlinger, Patrick Stremitzer, Stefan Bodingbauer, Martin Kaczirek, Klaus Sci Rep Article Postoperative liver dysfunction remains a major concern following hepatic resection. In order to identify patients who are at risk of developing liver dysfunction, indocyanine green (ICG) clearance has been proposed to predict postoperative liver function. All patients who underwent liver resection at the Medical University Vienna, Austria between 2006 and 2015 with preoperative ICG clearance testing (PDR, R15) were analyzed in this study. Postoperative liver dysfunction was analyzed as defined by the International Study Group of Liver Surgery. Overall, 698 patients (male: 394 (56.4%); female: 304 (43.6%)) with a mean age of 61.3 years (SD: 12.9) were included in this study, including 313 minor liver resections (44.8%) and 385 major liver resections (55.2%). One hundred and seven patients developed postoperative liver dysfunction after liver resection (15.3%). Factors associated with liver dysfunction were: male sex (p = 0.043), major liver resection (p < 0.0001), and preoperative ICG clearance (PDR (p = 0.002) and R15 (p < 0.0001)). Notably ICG clearance was significantly associated with liver dysfunction in minor and major liver resections respectively and remained a predictor upon multivariable analysis. An optimal cut-off for preoperative ICG clearance to accurately predict liver dysfunction was PDR < 19.5%/min and R15 > 5.6%. To the best of our knowledge, this is the largest study analyzing the predictive value of preoperative ICG clearance assessment in patients undergoing liver resection. ICG clearance is useful to identify patients at risk of postoperative liver dysfunction. Nature Publishing Group UK 2019-06-10 /pmc/articles/PMC6557886/ /pubmed/31182746 http://dx.doi.org/10.1038/s41598-019-44815-x Text en © The Author(s) 2019 Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Article
Schwarz, Christoph
Plass, Immanuel
Fitschek, Fabian
Punzengruber, Antonia
Mittlböck, Martina
Kampf, Stephanie
Asenbaum, Ulrika
Starlinger, Patrick
Stremitzer, Stefan
Bodingbauer, Martin
Kaczirek, Klaus
The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title_full The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title_fullStr The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title_full_unstemmed The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title_short The value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
title_sort value of indocyanine green clearance assessment to predict postoperative liver dysfunction in patients undergoing liver resection
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6557886/
https://www.ncbi.nlm.nih.gov/pubmed/31182746
http://dx.doi.org/10.1038/s41598-019-44815-x
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