Value of indocyanine green clearance test in selective surgical treatment of portal hypertension

Abstract:

Objective：To assess the value of indocyanine green clearance test in selective surgical treatment of portal hypertension. Methods：Clinical data of 47 portal hypertension patients who received surgical treatment in the First Affiliated Hospital of Chongqing Medical University from April 2011 to May 2013 were collected. According to indocyanine green clearance at 15 min（ICGR15），these patients were divided into group A（ICGR15<10%），group B（10%≤ICGR15<30%） and group C（ICGR15≥30%）. According to postoperative liver dysfunction，they were divided into team M with mild liver dysfunction and team S with sever liver dysfunction. Clinical data were compared among these groups. Results：Among groups A，B，C，Child-Pugh score，blooding amount and operation time were similar（P >0.05）；the lowest the postoperative serum albumin（P=0.002），the highest the postoperative serum bilirubin（P=0.012）；the postoperative recovery time of liver function（P=0.002） and rate of postoperative severe liver dysfunction（P=0.023） were significantly different among groups. Between team M and team S，preoperative ICGR15 was the only variant parameter（P=0.027）. Conclusion：For selective surgical treatment of portal hypertension，postoperative liver function mainly depends on functional liver re－serve，not surgical procedure. Indocyanine green clearance test is useful for accurate assessment of liver function and it could be a predic－tor of severe liver dysfunction. Recovery of functional liver reserve should be one of the goals preoperative treatment.