Document Detail


Role of quantification of hepatic steatosis and future remnant volume in predicting hepatic dysfunction and complications after liver resection for colorectal metastases: a pilot study.
MedLine Citation:
PMID:  22321038     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: Accurate prediction of safe remnant liver volume to minimize complications following liver resection remains challenging. The aim of this study was to assess whether quantification of steatosis improved the predictive value of preoperative volumetric analysis.
METHODS: Thirty patients undergoing planned right or extended right hemi-hepatectomy for colorectal metastases were recruited prospectively. Magnetic resonance imaging was used to assess the level of hepatic steatosis and future remnant liver volume. These data were correlated with data on postoperative hepatic insufficiency, complications and hospital stay. Correlations of remnant percentage, remnant mass to patient mass and remnant mass to body surface area with and without steatosis measurements were assessed.
RESULTS: In 10 of the 30 patients the planned liver resection was altered. Moderate-severe postoperative hepatic dysfunction was seen in 17 patients. Complications arose in 14 patients. The median level of steatosis was 3.8% (range: 1.2-17.6%), but was higher in patients (n= 10) who received preoperative chemotherapy (P= 0.124), in whom the median level was 4.8% (range: 1.5-17.6%). The strongest correlation was that of remnant liver mass to patient mass (r= 0.77, P < 0.001). However, the addition of steatosis quantification did not improve this correlation (r= 0.76, P < 0.001).
CONCLUSIONS: This is the first study to combine volumetric with steatosis quantifications. No significant benefit was seen in this small pilot. However, these techniques may be useful in operative planning, particularly in patients receiving preoperative chemotherapy.
Authors:
Alastair L Young; Dan Wilson; Janice Ward; John Biglands; J Ashley Guthrie; K Rajendra Prasad; Giles J Toogood; Philip J Robinson; J Peter A Lodge
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2012-01-16
Journal Detail:
Title:  HPB : the official journal of the International Hepato Pancreato Biliary Association     Volume:  14     ISSN:  1477-2574     ISO Abbreviation:  HPB (Oxford)     Publication Date:  2012 Mar 
Date Detail:
Created Date:  2012-02-10     Completed Date:  2012-06-04     Revised Date:  2013-06-26    
Medline Journal Info:
Nlm Unique ID:  100900921     Medline TA:  HPB (Oxford)     Country:  England    
Other Details:
Languages:  eng     Pagination:  194-200     Citation Subset:  IM    
Copyright Information:
© 2012 International Hepato-Pancreato-Biliary Association.
Affiliation:
Department of Hepatobiliary Surgery, St James's University Hospital, Leeds, UK.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Colorectal Neoplasms / pathology*
England
Fatty Liver / complications,  pathology*
Female
Hepatectomy / adverse effects*
Hepatic Insufficiency / etiology,  physiopathology
Humans
Length of Stay
Liver / pathology*,  physiopathology,  surgery*
Liver Neoplasms / complications,  secondary,  surgery*
Magnetic Resonance Imaging*
Male
Middle Aged
Organ Size
Pilot Projects
Postoperative Complications / etiology*,  physiopathology
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Time Factors
Treatment Outcome
Comments/Corrections

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