Measurement of liver function using hepatobiliary scintigraphy improves risk assessment in patients undergoing major liver resection

Cieslak, Kasia P.; Bennink, Roelof J.; Graaf, Wilmar de; Lienden, Krijn P. van; Besselink, Marc G.; Busch, Olivier R.; Gouma, Dirk J.; Gulik, Thomas M. van

doi:10.1016/j.hpb.2016.06.006

Cited by 92 publications

(61 citation statements)

References 15 publications

(18 reference statements)

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“…[17][18][19]. Эти обстоятельства диктуют необходимость использовать дополнительные методики, позволяющие выполнять количественную оценку функции планируемого остатка печени [20][21][22].…”

Section: материалы и методыunclassified

“…Начиная с 2010 г., ГБС с 99m Tc-mebrofenin для оценки функции планируемого остатка печени рутинно используется в Амстердаме (Голландия). За почти 10-летний период использования сцинтиграфии с 99m Tc-mebrofenin в оценке функции будущего остатка печени была показана прогностическая значимость в определении ППН [20]. Сцинтиграфия с 99m Tc-mebrofenin позволяет количественно оценить функцию планируемого остатка печени и может предоставить дополнительные данные по экскреции РФП.…”

Section: о б з о р ы л и т е р а т у р ы || L I T E R a T U R E R E Vunclassified

“…В обзоре детально изложены практические рекомендации по подготовке и укладке пациента, прописан протокол сбора данных (включающий 3 фазы: 1-я фаза -динамическая, 2-я фаза -ОФЭКТ/КТ, 3-я -динамическая (экскреторная фаза)) и варианты постпроцессинговой обработки [47]. Количественная оценка функции печени с использованием гибридных методов ядерной медицины предоставляет возможность одновременно получать как визуальную (анатомическую) так и функциональную информацию при исследовании печени, а применение предельно допустимого значения функции планируемого остатка печени ≥ 2,7 %/мин/м 2 при сцинтиграфии с 99m Tc-mebrofenin позволяет достоверно снизить количество случаев развития ППН [20,21]. Еще одним из преимуществ сцинтиграфии с 99m Tcmebrofenin следует считать возможность ее применения как у пациентов с нормальной и компрометированной функцией печени, используя предельно допустимые количественные значения функции будущего остатка печени ≥ 2,7 %/мин/м 2 , так и у больных, готовящихся к операции ALPPS (Associating liver partition and portal vein ligation for staged hepatectomy) [22,48].…”

Section: о б з о р ы л и т е р а т у р ы || L I T E R a T U R E R E Vunclassified

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Hepatobiliary scintigraphy in the preoperative assessment of the future remnant liver function (literature review and own examples)

Ликарь¹,

Ахаладзе²,

Румянцев³

2020

Ross. ž. det. gematol. onkol.

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Liver resection remains one of the most important option in combined treatment for liver tumors; however, it harbors the risk of developing posthepatectomy liver failure. The principal risk is associated with the quality and quantity of the future remnant liver. Therefore, preoperative assessment of the future remnant liver is essential in patients scheduled for major hepatectomy. Technetium-99m-mebrofenin hepatobiliary scintigraphy is increasingly applied for the quantitative assessment of liver function before major liver resection.

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Section: материалы и методыunclassified

Section: о б з о р ы л и т е р а т у р ы || L I T E R a T U R E R E Vunclassified

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Hepatobiliary scintigraphy in the preoperative assessment of the future remnant liver function (literature review and own examples)

Ликарь¹,

Ахаладзе²,

Румянцев³

2020

Ross. ž. det. gematol. onkol.

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“…The high hepatic uptake, low displacement by bilirubin, and, furthermore, low urinary excretion make mebrofenin the most suitable IDA agent for hepatic function assessment. We have used HBS in our center since the year 2000 for risk assessment of patients due to undergo any resection comprising three or more Couinaud segments [26,27].…”

Section: Scintigraphic Liver Function Testsmentioning

confidence: 99%

Current Modalities for the Assessment of Future Remnant Liver Function

et al. 2017

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While imaging studies such as computed tomography or magnetic resonance imaging allow the volumetric assessment of the liver segments, only indirect information is provided concerning the quality of the liver parenchyma and its actual functional capacity. Assessment of liver function is therefore crucial in the preoperative workup of patients who require extensive liver resection and in whom portal vein embolization is considered. This review deals with the modalities currently available for the measurement of liver function. Passive liver function tests include biochemical parameters and clinical grading systems such as the Child-Pugh and MELD scores. Dynamic quantitative tests of liver function can be based on clearance capacity tests such as the indocyanine green (ICG) clearance test. Although widely used, discrepancies have been reported for the ICG clearance test in relation with clinical outcome. Nuclear imaging studies have the advantage of providing simultaneous morphologic (visual) and physiologic (quantitative functional) information about the liver. In addition, regional (segmental) differentiation allows specific functional assessment of the future remnant liver. Technetium-99m (^99mTc)-galactosyl human serum albumin scintigraphy and ^99mTc-mebrofenin hepatobiliary scintigraphy potentially identify patients at risk for post-resectional liver failure who might benefit from liver-augmenting techniques. As there is no one test that can measure all the components of liver function, liver functional reserve is estimated based on a combination of clinical parameters and quantitative liver function tests.

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“…Combining HBS with SPECT-CT (single photon emission computed tomographycomputed tomography) offers quantitative information regarding segmental liver function and therefore provides an accurate measure of the function of the FLR. 20 In a preliminary report Kambakamba et al 21 could show that the kinetic growth rate was a predictor for postoperative liver failure after ALPPS with a cutoff-point of 6% per day.…”

Section: Introductionmentioning

confidence: 98%

Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Registry: What Have We Learned?

2020

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In 2007, the first associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) procedure was performed in Regensburg, Germany. ALPPS is a variation of twostage hepatectomy to induce rapid liver hypertrophy allowing the removal of large tumors otherwise considered irresectable due to a too small future liver remnant. In 2012, the international ALPPS registry was created, and it now contains more than 1,000 cases. During the past years, improved patient selection and refinements in operative techniques, in particular, less invasive approaches such as Partial ALPPS, Tourniquet ALPPS, Ablation-assisted ALPPS, Hybrid ALPPS or Laparoscopic or Robotic approaches, have resulted in significant improvements in safety. The most frequent indication for ALPPS is colorectal liver metastases. In the first randomized controlled study, ALPPS provided a higher resectability rate than conventional two-stage hepatectomy, with similar complication rates. Long-term outcome data are still missing. The initial results of ALPPS for hepatocellular carcinoma and for perihilar cholangiocarcinoma were devastating, but with progress in surgical technic and better patient selection, ALPPS could serve as a treatment alternative in carefully selected cases, even for these tumors. ALPPS has enlarged the armamentarium of hepato-pancreato-biliary surgeons, but there is still discussion regarding how to use this novel technique, which may allow resection of tumors that are otherwise deemed irresectable.

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Measurement of liver function using hepatobiliary scintigraphy improves risk assessment in patients undergoing major liver resection

Abstract: Background: 99m Tc-mebrofenin-hepatobiliary-scintigraphy (HBS) enables measurement of future

Cited by 92 publications

References 15 publications

Hepatobiliary scintigraphy in the preoperative assessment of the future remnant liver function (literature review and own examples)

Hepatobiliary scintigraphy in the preoperative assessment of the future remnant liver function (literature review and own examples)

Current Modalities for the Assessment of Future Remnant Liver Function

Associated Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS) Registry: What Have We Learned?

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