Miki A, Sakuma Y, Ohzawa H, Saito A, Meguro Y, Watanabe J, Morishima K, Endo K, Sasanuma H, Shimizu A, Lefor AK, Yasuda Y, Sata N. Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma. World J Gastroenterol 2022; 28(38): 5614-5625 [PMID: 36304091 DOI: 10.3748/wjg.v28.i38.5614]
Corresponding Author of This Article
Atsushi Miki, MD, PhD, Assistant Professor, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Tochigi, Japan. amiki@jichi.ac.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Retrospective Study
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Miki A, Sakuma Y, Ohzawa H, Saito A, Meguro Y, Watanabe J, Morishima K, Endo K, Sasanuma H, Shimizu A, Lefor AK, Yasuda Y, Sata N. Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma. World J Gastroenterol 2022; 28(38): 5614-5625 [PMID: 36304091 DOI: 10.3748/wjg.v28.i38.5614]
World J Gastroenterol. Oct 14, 2022; 28(38): 5614-5625 Published online Oct 14, 2022. doi: 10.3748/wjg.v28.i38.5614
Clearance of the liver remnant predicts short-term outcome in patients undergoing resection of hepatocellular carcinoma
Atsushi Miki, Yasunaru Sakuma, Hideyuki Ohzawa, Akira Saito, Yoshiyuki Meguro, Jun Watanabe, Kazue Morishima, Kazuhiro Endo, Hideki Sasanuma, Atsushi Shimizu, Alan Kawarai Lefor, Yoshikazu Yasuda, Naohiro Sata
Atsushi Miki, Yasunaru Sakuma, Hideyuki Ohzawa, Akira Saito, Yoshiyuki Meguro, Jun Watanabe, Kazue Morishima, Kazuhiro Endo, Hideki Sasanuma, Atsushi Shimizu, Alan Kawarai Lefor, Yoshikazu Yasuda, Naohiro Sata, Department of Surgery, Jichi Medical University, Shimotsuke 329-0498, Tochigi, Japan
Author contributions: Miki A, Sakuma Y, Shimizu A and Yasuda Y designated the overall concept and outline the manuscript; Ohzawa H, Saito A, Meguro Y, Watanabe J, Morishima K, Endo K, Sasanuma H, and Sata N contributed to the discussion and design of the manuscript; Miki A and Lefor AK contributed to the writing, editing the manuscript, illustrations, and review of literature.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of Jichi Medical University, Approval No. A21-029.
Informed consent statement: Written informed consent from any patient for data collection in a prospectively collected data base is available. However, the need for written informed consent for this study was waived by the Institutional Review Board of Jichi Medical University in view of the retrospective design of the study, based on national and local guidelines such as the fact that all clinical/ laboratory measurements and procedures were part of routine care.
Conflict-of-interest statement: The authors declare no conflicts of interest for this study.
Data sharing statement: The database contains highly confidential data which may provide insight in clinical and personnel information about patients and lead to their identification. Therefore, according to organizational restrictions and regulations these data cannot be made publicly available. However, the datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Atsushi Miki, MD, PhD, Assistant Professor, Department of Surgery, Jichi Medical University, 3311-1 Yakushiji, Shimotsuke 329-0498, Tochigi, Japan. amiki@jichi.ac.jp
Received: November 16, 2021 Peer-review started: November 16, 2021 First decision: May 10, 2022 Revised: May 21, 2022 Accepted: August 16, 2022 Article in press: August 16, 2022 Published online: October 14, 2022 Processing time: 329 Days and 22.5 Hours
ARTICLE HIGHLIGHTS
Research background
Preoperative assessment of liver function is important to reduce the rate of complications.
Research motivation
Few studies evaluate the relationship of residual liver function to complications and prognosis using hepatic clearance.
Research objectives
To measure hepatic clearance of the remnant liver using 99mTc-galactosyl serum albumin (GSA) scintigraphy, single photon emission computed tomography, to elucidate the association between residual liver function and morbidity and mortality, and to identify risk factors for those factors.
Research methods
We collected data from 199 patients who underwent resection of hepatocellular carcinoma. Hepatic clearance of the remnant liver was measured using fusion images of 99mTc-labelled GSA liver scintigraphy and computed tomography scans. Risk factors were determined using logistic regression multivariate analysis.
Research results
Risk factors for posthepatectomy liver failure, morbidity, and mortality were low hepatic clearance of the remnant liver and intra-operative bleeding.
Research conclusions
Lower residual liver function is associated with a poor short-term prognosis.
Research perspectives
Preoperative estimation of remnant liver function is useful to determine the surgical approach.
