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Kim HJ, Kim CY, Hur YH, et al. Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection. Korean J Hepatobiliary Pancreat Surg. 2013;17(4):143-51doi: 10.14701/kjhbps.2013.17.4.143.
Kim, H. J., Kim, C. Y., Hur, Y. H., Koh, Y. S., Kim, J. C., Cho, C. K., & Kim, H. J. (2013). Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection. Korean journal of hepato-biliary-pancreatic surgery, 17(4), 143-51. https://doi.org/10.14701/kjhbps.2013.17.4.143
Kim, Hee Joon, et al. "Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection." Korean journal of hepato-biliary-pancreatic surgery vol. 17,4 (2013): 143-51. doi: https://doi.org/10.14701/kjhbps.2013.17.4.143
Kim HJ, Kim CY, Hur YH, Koh YS, Kim JC, Cho CK, Kim HJ. Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection. Korean J Hepatobiliary Pancreat Surg. 2013 Nov;17(4):143-51. doi: 10.14701/kjhbps.2013.17.4.143. Epub 2013 Nov 20. PMID: 26155230; PMCID: PMC4304515.
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Korean J Hepatobiliary Pancreat Surg. 2013 Nov;17(4):143-51. doi: 10.14701/kjhbps.2013.17.4.143. Epub 2013 Nov 20.

Comparison of remnant to total functional liver volume ratio and remnant to standard liver volume ratio as a predictor of postoperative liver function after liver resection.

Korean journal of hepato-biliary-pancreatic surgery

Hee Joon Kim, Choong Young Kim, Young Hoe Hur, Yang Seok Koh, Jung Chul Kim, Chol Kyoon Cho, Hyun Jong Kim

Affiliations

  1. Department of Surgery, Chonnam National University College of Medicine, Gwangju, Korea.

PMID: 26155230 PMCID: PMC4304515 DOI: 10.14701/kjhbps.2013.17.4.143

Abstract

BACKGROUNDS/AIMS: The future liver remnant (FLR) is usually calculated as a ratio of the remnant liver volume (RLV) to the total functional liver volume (RLV/TFLV). In liver transplantation, it is generally accepted that the ratio of the graft volume to standard liver volume (SLV) needs to be at least 30% to 40% to fit the hepatic metabolic demands of the recipient. The aim of this study was to compare RLV/TFLV versus RLV/SLV as a predictor of postoperative liver function and liver failure.

METHODS: CT volumetric measurements of RLV were obtained retrospectively in 74 patients who underwent right hemihepatectomy for a malignant tumor from January 2010 to May 2013. RLV and TFLV were obtained using CT volumetry, and SLV was calculated using Yu's formula: SLV (ml)=21.585×body weight (kg)(0.732)×height (cm)(0.225). The RLV/SLV ratio was compared with the RLV/TFLV as a predictor of postoperative hepatic function.

RESULTS: Postheptectomy liver failure (PHLF), morbidity, and serum total bilirubin level at postoperative day 5 (POD 5) were increased significantly in the group with the RLV/SLV ≤30% compared with the group with the RLV/SLV >30% (p=0.002, p=0.004, and p<0.001, respectively). But RLV/TFLV was not correlated with PHLF and morbidity (p=1.000 and 0.798, respectively). RLV/SLV showed a stronger correlation with serum total bilirubin level than RLV/TFLV (RLV/SLV vs. RLV/TFLV, R=0.706 vs. 0.499, R(2)=0.499 vs. 0.239).

CONCLUSIONS: RLV/SLV was more specific than RLV/TFLV in predicting the postoperative course after right hemihepatectomy. To determine the safe limit of hepatic resection, a larger-scaled prospective study is needed.

Keywords: Future liver remnant; Liver failure; Liver resection; Liver volumetry

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