Table of Contents
HPB Surgery
Volume 2017, Article ID 2948030, 8 pages
https://doi.org/10.1155/2017/2948030
Research Article

Child-Pugh Parameters and Platelet Count as an Alternative to ICG Test for Assessing Liver Function for Major Hepatectomy

Department of Surgery, The University of Hong Kong, Hong Kong

Correspondence should be addressed to See-Ching Chan; moc.liamg@nahcgnihcees

Received 15 February 2017; Revised 23 June 2017; Accepted 30 July 2017; Published 29 August 2017

Academic Editor: Dahmen Uta

Copyright © 2017 Kin-Pan Au et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. To study the correlations and discrepancies between Child-Pugh system and indocyanine green (ICG) clearance test in assessing liver function reserve and explore the possibility of combining two systems to gain an overall liver function assessment. Design. Retrospective analysis of 2832 hepatocellular carcinoma (HCC) patients graded as Child-Pugh A and Child-Pugh B with ICG clearance test being performed was conducted. Results. ICG retention rate at 15 minutes (ICG15) correlates with Child-Pugh score, however, with a large variance. Platelet count improves the correlation between Child-Pugh score and ICG15. ICG15 can be estimated using the following regression formula: estimated ICG15 (eICG15) = 45.1 + 0.435 × bilirubin − 0.917 × albumin + 0.491 × prothrombin time − 0.0283 × platelet (). Patients with eICG15 >20.0% who underwent major hepatectomy had a tendency towards more posthepatectomy liver failure (4.1% versus 8.0%, ) and higher in-hospital mortality (3.7% versus 8.0%, ). They also had shorter median overall survival ( versus years, ) and disease-free survival ( versus years, ). Conclusion. eICG15 can be predicted from Child-Pugh parameters and platelet count. eICG15 correlates with in-hospital mortality after major hepatectomy and predicts long-term survival.