Rapidmeasurementofindocyaninegreen retentionbypulsespectrophotometry:avalidation studyin70patientswithChild-PughAcirrhosis beforehepatectomyforhepatocellularcarcinoma

摘要

BACKGROUND: The  indocyanine  green  (ICG)  retention test  is  the  most  popular  liver  function  test  for  selecting patients for major hepatectomy. Traditionally, it is done using spectrophotometry with serial blood sampling. The newly-developed pulse spectrophotometry is a faster alternative, but its accuracy on Child-Pugh A cirrhotic patients undergoing hepatectomy for hepatocellular carcinoma has not been well documented. This study aimed to assess the accuracy of the LiMON®, one of the pulse spectrophotometry systems, in measuring preoperative ICG retention in these patients and to devise an easy formula for conversion of the results so that they can be compared with classical literature records where ICG retention was measured by the traditional method. METHODS: We measured the liver function of 70 Child-Pugh A  cirrhotic  patients  before  hepatectomy  for  hepatocellular carcinoma from September 2008 to January 2009. ICG retention at  15  minutes  measured  by  traditional  spectrophotometry (ICGR15) was compared with ICG retention at 15 minutes measured by the LiMON (ICGR15(L)). RESULTS: The median ICGR15 was 14.7% (5.6%-32%) and the median ICGR15(L) was 10.4% (1.2%-28%). The mean difference between them was -4.3606. There was a strong correlation  between  ICGR15  and  ICGR15(L)  (correlation coefifcient, 0.844; 95% conifdence interval, 0.762-0.899). The following formula was devised: ICGR15=1.16×ICGR15(L)+2.73. CONCLUSIONS: The LiMON provides a fast and repeatable way to measure ICG retention at 15 minutes, but with constant underestimation of the real value. Therefore, when comparing results  obtained  by  traditional  spectrophotometry  and  the LiMON, adjustment of results from the latter is necessary, and this can be done with a simple mathematical calculation using the above formula.