Faculty Collaboration Database

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. HPB (Oxford) 2012 Mar;14(3):194-200

Date

02/11/2012

Pubmed ID

22321038

Pubmed Central ID

PMC3371202

DOI

10.1111/j.1477-2574.2011.00426.x

Scopus ID

2-s2.0-84857046130 (requires institutional sign-in at Scopus site)   5 Citations

Abstract

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.

Author List

Young AL, Wilson D, Ward J, Biglands J, Guthrie JA, Prasad KR, Toogood GJ, Robinson PJ, Lodge JP

Author

Kondragunta Rajendra Prasad MBBS Professor in the Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Aged
Aged, 80 and over
Chemotherapy, Adjuvant
Colorectal Neoplasms
England
Fatty Liver
Female
Hepatectomy
Hepatic Insufficiency
Humans
Length of Stay
Liver
Liver Neoplasms
Magnetic Resonance Imaging
Male
Middle Aged
Organ Size
Pilot Projects
Postoperative Complications
Predictive Value of Tests
Prospective Studies
Reproducibility of Results
Severity of Illness Index
Time Factors
Treatment Outcome