HepatoBilioPancreaticLiver function assessment using 99mTc-GSA single-photon emission computed tomography (SPECT)/CT fusion imaging in hilar bile duct cancer: A retrospective study
Section snippets
Patients
Thirty HBDC patients who underwent major hepatectomy with extrahepatic bile resection between April 2009 and July 2014 were enrolled in the retrospective study. Preoperative liver function was assessed in all HBDC patients using the ICG test and 99mTc-GSA SPECT/CT fusion imaging. The study was approved by an institutional review board, with waiver of informed consent.
99mTc-GSA SPECT/CT fusion examination
All patients underwent preoperative biliary drainage. 99mTc-GSA SPECT/CT fusion examination was performed after patients had
Clinical characteristics
The clinical characteristics of the 30 patients are shown in the Table. The patient population comprised 17 males and 13 females with a median age of 71 years (range, 42–84 years). All 30 patients showed obstructive jaundice and received preoperative biliary drainage limited to the future remnant lobe. As a result, biliary decompression in the future remnant lobe and biliary dilatation in the future resected lobe were admitted in 25 (83%) patients. In the remaining 5 patients, biliary
Discussion
Preoperative remnant liver function assessment is crucial to avoid posthepatectomy liver dysfunction.1, 7 Few studies have investigated remnant liver function as indication for hepatectomy in HBDC. Two notable studies demonstrated the utility of remKICG value in predicting outcome after major hepatectomy for biliary cancer patients.1, 2 A remKICG value <0.05 was reported to be a useful and reliable cut-off value in selecting HBDC patients for hepatectomy.1, 2 This index, which is based on
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The authors have no conflicts of interest to declare.
This work was supported by the Kochi Organization for Medical Reformation and Renewal.