1995 Fiscal Year Final Research Report Summary
Preoperative evaluation of the safety zone of hepatectomy for the patients with hepatobiliary discases accompanying with liver cirrhosis or jaundice.
| Project/Area Number |
06671301
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| Research Category |
Grant-in-Aid for General Scientific Research (C)
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| Allocation Type | Single-year Grants |
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| Research Field |
Digestive surgery
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| Research Institution | Wakayama Medical School |
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Principal Investigator |
ISHIMOTO Kiwao Wakayama Medical School, Second Department associate professor, 医学部, 助教授 (40176227)
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| Co-Investigator(Kenkyū-buntansha) |
OHNISHI Hironobu Wakayama Medical School, Second Department assistant staff, 医学部, 助手 (40264882)
UCHIYAMA Kazuhisa Wakayama Medical School, Second Department assistant professor, 医学部, 講師 (80232867)
TANIMURA Hiroshi Wakayama Medical School, Second Department professor, 医学部, 教授 (10026990)
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| Project Period (FY) |
1995 – 1996
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| Keywords | Bile acid tolerance test / Functional resurve of the liver / liver cirrhosis |
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| Research Abstract |
The significance of oral ursodeoxycholic acid (UDCA) tolerance test and liver volume prediction with CT-scan using a new computer soft system was investigated in 60 patients in order to estimate preoperatively the safety zone of hepatectomy for patients with hepatobiliary diseases accompanying with liver cirrhosis or jaundice.
The area under the curve of total bile acid levels (T・AUC) in UDCA tolerance test was significantly correlated with the ICG retention rate (ICG R15) (correlation coefficient : 0.83), and was more useful in 4 patients than ICG R15.
Preoperative CT-scan prediction of the liver volume was performed in 17 patients, and was showed to correlate closely with the weight of resected liver volume.
In 60 patients, the prediction of resected liver volume calculated preoperatively and other liver function tests of these patients were compared to postoperative prognosis, including 4 patients who died of hepatic failure after hepatectomy. Postoperative prognosis (Y) of these Patients was computed by the following multiple regression equation. :
Y=3.48X+1.61DELTAUDCA120-0.12T・AUC+1.68R15-31.0
proportion 0.58 (p<0.01) ; the Y-score was represented as 100 (died of hepatic failure) or 0 (discharged) point ; X : normal liver volume=resected liver volume-the vulume of the tumor ; R15 (%) : retention rate of ICG ; T・AUC (mumol・h/l) ; DELTAUDCA120 (mumol/l) : the UDCA levels increased from 0 min to 120 min after loading
From these results, it was showed that the patients with more than 25 points could be predicted to fall into hepatic failure after hepatectomy.
Conclusion. UDCA tolerance test and liver volume prediction with CT-scan using a new computer soft system are very useful to estimate preoperative functional reserve of the liver.
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