| International Session (Symposium) 4 (JSGS・JSH) |
| Fri. November 2nd 9:40 - 12:00 Room 12: Kobe International Conference Center Main Hall |
| Indication of liver surface laparoscopic liver resection (LLR) to LC patients | |||
| Zenichi Morise1, Yukio Asano1, Akihiko Horiguchi1 | |||
| 1Fujita Health University Sch of Med | |||
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| The volume of the liver resected in each patient is planned on tumor condition and location. However, HCC patients sometimes develop postoperative liver failure due to poor functional reserve thereafter. ICGR15 has been an excellent tool for predicting how much liver volume could be resected in each patient. On the other, minimum non-tumorous liver parenchyma is resected in liver surface tumorectomy. In those cases, most important is, not how much liver volume could be resected, but whether the patient could tolerate the surgical stress. LLR minimizes the surgery-induced injury caused by disruption of the collateral blood and lymphatic flow with laparotomy and mobilization, and leads to decreasing ascites and liver failure. The indication of liver surface partial LLR may need to be different from the others. We performed 152 LLR. There were 19 patients with more than 30% ICGR15. The 19 patients were 6, 11, and 2 of CP-A, B, and C and 2, 11, and 5 patients of Liver damage-A,B, and C. Liver surface small LLR for CP-B/C (up to score of 10) is applied, only when the patients could have been doing light labor before surgery. 7 patients (D) died of HCC or liver failure within 24 months. When D patients were compared to 10 patients who survived (A), there is significant difference in CP score, but not in MELD, ALBI, ICGR15 and LD. All D patients, but only 3 out of 11 A patients, had esophageal varices. 5 out of 7 D patients have below 60,000 plt counts. ICGR15 above 30-40% is not well-correlated with actual liver function and may not be suitable selection criteria of surface LLR. CP score is the promising indicator which correlates well to patient’s performance status and prognosis. Portal hypertension indicated by varices and platelet counts is as well. |
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Index Term 1: laparoscopic liver resection Index Term 2: liver cirrhosis |
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