99mTc-mebrofenin hepatobiliary scintigraphy predicts liver failure following major liver resection for perihilar cholangiocarcinoma. Issue 10 (October 2017)

• Record Type: Journal Article
• Authors: Olthof, Pim B.; Coelen, Robert J.S.; Bennink, Roelof J.; Heger, Michal; Lam, Meng F.; Besselink, Marc G.; Busch, Olivier R.; van Lienden, Krijn P.; van Gulik, Thomas M.
• Is Part Of: HPB. Volume 19:Issue 10(2017)
• Page Start: 850
• Page End: 858
• Publication Date: 2017-10
• Subjects: Liver -- Diseases -- Periodicals; Biliary tract -- Diseases -- Periodicals; Pancreas -- Diseases -- Periodicals; 616.362005
• DOI: 10.1016/j.hpb.2017.05.007
• Languages: English
• ISSNs: 1365-182X

Abstract

Abstract: Background: Posthepatectomy liver failure (PHLF) is a threatening complication after liver surgery, especially in perihilar cholangiocarcinoma (PHC). This study aimed to assess the value of preoperative assessment of liver function using 99m Tc-mebrofenin hepatobiliary scintigraphy (HBS) to predict PHLF in comparison with liver volume in PHC patients. Methods: All patients who underwent resection of suspected PHC in a single center between 2000 and 2015 were included in the analysis. PHLF was graded according to the ISGLS criteria with grade B/C considered clinically relevant. A cut-off value for the prediction of PHLF was calculated using the receiver operating characteristic curve (ROC) analysis. Results: A total of 116 patients were included of which 27 (23%) suffered of PHLF. ROC values for the prediction of PHLF were 0.74 (0.63–0.86) for future liver remnant function and 0.63 (0.47–0.80) for volume. A cut-off for liver function was set at 8.5%/min, which resulted in a negative predictive value of 94% and positive predictive value of 41%. Conclusions: Assessment of liver function with HBS had better predictive value for PHLF than liver volume in patients undergoing major liver resection for suspected PHC. The cut-off of 8.5%/min can help to select patients for portal vein embolization and might help to reduce postoperative liver failure.