Value of ICG-R15 on postoperative day 3 in predicting liver dysfunction after hepatectomy for hepatocellular carcinoma
Objective: To investigate the value of indocyanine green retention test at 15 minutes (ICG-R15) on postoperative day (POD) 3 in predicting the occurrence of liver dysfunction after hepatectomy for hepatocellular carcinoma (HCC). Methods: The clinical data of 119 HCC patients undergoing hepatectomy from January 2015 to February 2016 were reviewed. The relations of the occurrence of postoperative liver dysfunction with preoperative and POD 3 ICG-R15 were analyzed, and the difference in predicting the occurrence of postoperative liver dysfunction between preoperative and POD 3 ICG-R15 was also compared. Results: Postoperative liver dysfunction occurred in 33 (27.7%) of the 119 patients. In patients with and without liver dysfunction, the average preoperative ICG-R15 was 9.7% and 5.2%, and POD 3 ICG-R15 was 11.8% and 5.3% respectively, and either the preoperative or POD 3 ICG-R15 was significantly different between patients with and without liver dysfunction (both P<0.05). Results of stratified analysis showed that the incidence of postoperative liver dysfunction was increased with the elevation of either preoperative or POD 3 ICG-R15, with statistical difference noted between patients with ICG-R15<10% and >20% (both P<0.05). The area under the curve of ROC of POD 3 ICG-R15 for prediction of preoperative liver dysfunction was larger than that of preoperative ICG-R15, and the cut-off value for the former was 7.75 (sensitivity: 66.7%; specificity: 83.7%) and for the latter was 3.35 (sensitivity: 84.8%; specificity: 46.5%), respectively. Conclusion: POD 3 ICG-R15 can be used for predicting liver dysfunction after hepatectomy for HCC similar to that of preoperative ICG-R15, and may even be superior to the latter.