Post-hepatectomy liver failure after major hepatic surgery: not only size matters

European Radiology
Ulrika AsenbaumRichard Nolz

Abstract

To compare the value of functional future liver remnant (functFLR) to established clinical and imaging variables in prediction of post-hepatectomy liver failure (PHLF) after major liver resection. This retrospective, cross-sectional study included 62 patients, who underwent gadoxetic acid enhanced MRI and MDCT within 10 weeks prior to resection of ≥ 4 liver segments. Future liver remnant (FLR) was measured in MDCT using semi-automatic software. Relative liver enhancement for each FLR segment was calculated as the ratio of signal intensity of parenchyma before and 20 min after i.v. administration of gadoxetic acid and given as mean (remnantRLE). Established variables included indocyanine green clearance, FLR, proportion of FLR, weight-adapted FLR and remnantRLE. functFLR was calculated as FLR multiplied by remnantRLE and divided by patient's weight. The association of measured variables and PHLF was tested with univariate and multivariate logistic regression analysis and receiver operator characteristics (ROC) curves compared with the DeLong method. Sixteen patients (25.8%) experienced PHLF. Univariate logistic regression identified FLR (p = 0.015), proportion of FLR (p = 0.004), weight-adapted FLR (p = 0.003), remnantRLE (p = 0...Continue Reading

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Citations

Sep 8, 2020·Surgery Today·Yoji Kishi, Jean-Nicolas Vauthey
Oct 10, 2020·Abdominal Radiology·Sarah Poetter-LangAhmed Ba-Ssalamah
Sep 19, 2020·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·Jon Arne Søreide, Rahul Deshpande
Aug 10, 2021·World Journal of Clinical Cases·Xin-Xin WangXiao-Jun Yang
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Aug 29, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Mario GhosnJuan C Camacho

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