Remnant Liver Volume to Body Weight Ratio ≥ 0.5%: A New Cut-Off to Estimate Postoperative Risks after Extended Resection in Noncirrhotic Liver

Truant, Stéphanie; Oberlin, O.; Sergent, Géraldine; Lebuffe, Gilles; Gambiez, L; Ernst, Olivier; Pruvot, François‐René

doi:10.1016/j.jamcollsurg.2006.09.007

Cited by 269 publications

(192 citation statements)

References 49 publications

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“…For the purpose of this study, the required FRL was additionally calculated using the FRL-BWR method 3 and standardized liver volumetry as proposed by Vauthey. 4 According to the FRL-BWR, the minimal FRL-volume should be at least 0.5% of patient's weight.…”

Section: Volumetric Measurementsmentioning

confidence: 99%

“…4 According to the FRL-BWR, the minimal FRL-volume should be at least 0.5% of patient's weight. 3 The standardized liver volumetry uses a validated mathematical formula in order to estimate the total liver volume (estimated total liver volume). The ratio of the FRLvolume, measured with CT-volumetry, and the estimated total liver volume represents the percentage of liver tissue that will remain after the resection and is called standardized FRLvolume.…”

Section: Volumetric Measurementsmentioning

confidence: 99%

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

Cieslak

Bennink

Graaf

et al. 2016

HPB

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Section: Volumetric Measurementsmentioning

confidence: 99%

Section: Volumetric Measurementsmentioning

confidence: 99%

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

Cieslak

Bennink

Graaf

et al. 2016

HPB

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“…Previous studies have indicated that the size of the FLR should be at least 25 per cent of total liver volume1 or a ratio greater than 0·5 between FLR and bodyweight2 3. Various strategies such as portal vein embolization (PVE)4 and two‐stage hepatectomy5 have been developed to increase FLR and enable surgical therapy in patients otherwise deemed unresectable.…”

Section: Introductionmentioning

confidence: 99%

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

et al. 2017

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BackgroundThe underlying mechanism of liver regeneration after Associating Liver Partition and Portal vein ligation (PVL) for Staged hepatectomy (ALPPS) is still unclear. The aim of this study was to evaluate the relationship between future liver remnant (FLR) volume, liver regeneration characteristics and restoration of function in an experimental model of ALPPS.MethodsAn ALPPS model in rats was developed with selective PVL, parenchymal transection and partial hepatectomy (step 1), followed by resection of the liver (step 2). Three different ALPPS groups with FLR sizes of 30, 20 and 10 per cent of total liver volume were compared with sham‐operated controls and animals undergoing resection of left lateral lobe and 90 per cent PVL with respect to morbidity, mortality, liver regeneration and function.ResultsThree of 15 animals that had ALPPS with 10 per cent FLR (ALPPS10) died after step 1. Ascites developed in two of five rats that had ALPPS with 20 per cent FLR and in three of four animals in the ALPPS10 group after step 2. Although the relative increments in FLR size and growth rates were highest in the ALPPS groups, small FLR size was associated with a sustained increase in levels of serum aminotransferases and bilirubin, a lower albumin concentration, severe sinusoidal injury, increased expression of proliferation markers and increased activation of hepatic progenitor cells after step 2.ConclusionThere is discordance between FLR volume increase and functional restoration after the ALPPS procedure.

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“…The predicted LiMAx value after surgery is approximately 31% of 639 µ g/kg/h. This value of 198 µ g/kg/h is below the normal liver capacity, but in a range in which the recovery of the liver is expected without complications [21,30,[32][33][34][35][36]. Thus, it is possible to predict this operation is safe.…”

Section: Operation Planningmentioning

confidence: 93%

Liver Status Assessment by Spectrally and Time Resolved IR Detection of Drug Induced Breath Gas Changes

et al. 2016

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Abstract:The actual metabolic capacity of the liver is crucial for disease identification, liver therapy, and liver tumor resection. By combining induced drug metabolism and high sensitivity IR spectroscopy of exhaled air, we provide a method for quantitative liver assessment at bedside within 20 to 60 min. Fast administration of 13 C-labelled methacetin induces a fast response of liver metabolism and is tracked in real-time by the increase of 13 CO 2 in exhaled air. The 13 CO 2 concentration increase in exhaled air allows the determination of the metabolic liver capacity (LiMAx-test). Fluctuations in CO 2 concentration, pressure and temperature are minimized by special gas handling, and tracking of several spectrally resolved CO 2 absorption bands with a quantum cascade laser. Absorption measurement of different 12 CO 2 and 13 CO 2 rotation-vibration transitions in the same time window allows for multiple referencing and reduction of systematic errors. This FLIP (Fast liver investigation package) setup is being successfully used to plan operations and determine the liver status of patients.

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Remnant Liver Volume to Body Weight Ratio ≥ 0.5%: A New Cut-Off to Estimate Postoperative Risks after Extended Resection in Noncirrhotic Liver

Cited by 269 publications

References 49 publications

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

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

Experimental evaluation of liver regeneration patterns and liver function following ALPPS

Liver Status Assessment by Spectrally and Time Resolved IR Detection of Drug Induced Breath Gas Changes

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