Preoperative prediction of postoperative reserve hepatic function for liver surgery for hepatobiliary, pancreatic...

To perform safer hepatic resection for hepatobiliary-pancreatic cancer, the possibility of preoperative prediction of postoperative reserve hepatic function was assessed using hepatobiliary scintigraphy. After intravenous administration of Tc-99m-pyridoxyl-5-methyltryptophan in 23 patients, the time-activity curves of region of interest over the heart and liver were generated, and peak and one-fourth clearance times were calculated, which were compared with biochemical data. The parameters were significantly related to protein syntheses (prothrombine time and hepaplastin test) and indocyanine-green dye excretion, but not to hepatobiliary enzymes. So we hypothesized 'when the curve left by subtracting the resected area from the whole liver was larger than one-third of the total liver curve, the surgery would be safe', which we applied to another eight patients, clarifying the hypothesis. Hepatobiliary scintigraphy can be a promising procedure in the assessment of partial liver function, and the study will contribute to a safer liver surgery.