Indocyanine green plasma clearance rate and 99mTc-galactosyl human serum albumin single-photon emission computed tomography evaluated preoperative remnant liver

Table 1 Patient characteristics

Characteristics	Numerical value
Number of patients	23
Age (yr), mean ± SD	64 ± 13.8
Sex (male/female)	18/5
Desease
HCC	9
Bile duct cancer	9
Liver metastasis	4
Others	1
Preoperative factor
Albumin (mean ± SD)	3.8 ± 0.5
Total bilirubin (mean ± SD)	0.7 ± 0.4
PT-INR (mean ± SD)	1.3 ± 0.2
Plt (mean ± SD)	23 ± 6
Liver damage (A/B)	20/3
Child-Pugh score (5/6/7)	16/6/1
ICG-R15 (mean ± SD)	10.6 ± 4.6
KICG (mean ± SD)	0.153 ± 0.030

HCC: Hepatocellular carcinoma; PT-INR: Prothrombin time/international normalised ratio; Plt: Platelet; ICG: Indocyanine green plasma; KICG: Indocyanine green plasma clearance rate.

Table 2 Perioperative outcomes

Outcome	Numerical value
Remnant liver KICG
Pre PVE a-rem-KICG (mean ± SD)	0.044 ± 0.010
Pre PVE f-rem-KICG (mean ± SD)	0.042 ± 0.012
Post PVE a-rem-KICG (mean ± SD)	0.062 ± 0.016
Post PVE f-rem-KICG (mean ± SD)	0.075 ± 0.017
The increased amount of a-rem-KICG (mean ± SD)	0.018 ± 0.015
The increased amount of f-rem-KICG (mean ± SD)	0.034 ± 0.022
Post PVE f-rem-KICG minus a-rem-KICG (mean ± SD)	0.012 ± 0.013
Operative parameters
Operative procedure
Right hepatectomy	16
Right trisectionectomy	6
Left trisectionectomy	1
Combined resection
Pancreaticoduodenectomy	2
Bile duct reconstruction	9
Resection volume (mL), mean ± SD	775 ± 237
Blood loss (mL), mean ± SD	576 ± 426
Operative time (min), mean ± SD	474 ± 156
Postoperative outcomes
Complication (> Clavian-Dindo grade II)	6, 26.1%
PHLF	1, 4.3%
Hospital stay (d), mean ± SD	23 ± 28
90-d mortality	0

KICG: Indocyanine green plasma clearance rate; PVE: Portal vein embolization; PHLF: Post-hepatectomy liver failure; a-rem-KICG: Anatomical volume remnant indocyanine green plasma clearance rate; f-rem-KICG: Functional volume remnant indocyanine green plasma clearance rate.

Table 3 Details of the six marginal cases (anatomical volume remnant indocyanine green plasma clearance rate < 0.05 and functional volume remnant indocyanine green plasma clearance rate > 0.05)

Case number	Age	Diagnosis	Post-PVE a-rem-KICG	Post-PVE f-rem-KICG	Operative procedure	Operative time (min)	Blood loss (mL)	Postoperative complications	PHLF	Hospital stay (d)
1	59	CCA	0.049	0.062	Right trisectionectomy	567	654	None	None	9
2	64	CCA	0.049	0.059	HPD (right hemihepatectomy)	879	924	Grade IIIa, pancreatic fistula	None	39
3	73	CCA	0.045	0.054	Right trisectionectomy	636	718	Grade IIIb, abdominal abscess	None	24
4	76	HCC	0.043	0.051	Right hemi hepatectomy	380	766	None	None	8
5	76	CCA	0.048	0.054	Left trisectionectomy	588	1044	Grade IIIa, ascites	None	128
6	70	CRLM	0.049	0.063	Right hemi hepatectomy	470	412	None	None	14

CCA: Clear cell acanthoma; HCC: Hepatocellular carcinoma; CRLM: Colorectal liver metastases; PVE: Portal vein embolization; KICG: Indocyanine green plasma clearance rate; HPD: Hepatopancreatoduodenectomy; PHLF: Post-hepatectomy liver failure.

Table 4 Univariate analysis of postoperative outcomes in marginal group and not marginal group

	Not-marginal group1	Marginal group2	P value
PT-INR max (mean ± SD)	1.43 ± 0.27	1.42 ± 0.19	0.4700
T-Bil max (mean ± SD)	2.2 ± 1.4	1.8 ± 1.0	0.2102
Complication (> Clavian-Dindo grade II)	3, 20%	3, 50%	0.2906
PHLF	1, 6.7%	0, 0%	0.5169
Hospital stay (mean ± SD)	19 ± 18	37 ± 46	0.9011
90-d mortality	0, 0%	0, 0%	-

¹Anatomical volume remnant indocyanine green plasma clearance rate > 0.05, functional volume remnant indocyanine green plasma clearance rate > 0.05.

²Anatomical volume remnant indocyanine green plasma clearance rate < 0.05, functional volume remnant indocyanine green plasma clearance rate > 0.05

PT-INR: Prothrombin time/international normalised ratio; T-Bil: Total bilirubin; PHLF: Post-hepatectomy liver failure.