Index for predicting post-operative residual liver function by pre-operative dynamic liver SPET

Area of Science:

• Hepatology
• Nuclear Medicine
• Surgical Oncology

Background:

• Hepatic resection requires accurate prediction of residual liver function to prevent post-operative complications.
• Assessing functional liver volume and clearance is crucial for pre-surgical risk stratification.

Purpose of the Study:

• To develop and validate a predictive index for residual liver function before hepatic resection.
• To assess the correlation between the predictive index and post-hepatectomy hepatic failure.

Main Methods:

• Utilized liver dynamic single photon emission tomography (SPET) with 99Tcm-Sn colloid in 47 patients undergoing liver resection.
• Combined clearance values with functional liver volume to create a predictive index.
• Monitored patients for hepatic failure and mortality post-operation.

Main Results:

• No immediate operation-related deaths occurred.
• Three patients died from hepatic failure (>1 month post-operation) with predictive indices of 0.24, 0.33, and 0.34.
• Patients with a predictive index above 0.35 showed no symptoms of hepatic failure or mortality.

Conclusions:

• The developed predictive index effectively estimates residual liver function post-hepatectomy.
• A predictive index value above 0.35 is associated with a significantly low probability of hepatic failure.
• This index can aid in pre-surgical planning to improve outcomes for patients undergoing liver resection.