To Evaluate The Value Of Preoperative Indocyanine Green (ICG) Clearance Test For Predicting Liver Reserve Function In Patients With Primary Liver Cancer And Complicated With Hepatitis B Cirrhosis

Objective: To evaluate the clinical application value of indocyanine green(ICG)clearance test in preoperative liver reserve function of patients with hepatocellular carcinoma complicated with hepatitis B cirrhosis.It is used to accurately assess the preoperative liver reserve function,guide the extent of liver resection,and effectively reduce postoperative complications.Methods: A retrospective analysis of 58 patients who underwent surgical resection of primary hepatocellular carcinoma complicated with hepatitis B cirrhosis.From January 2015 to September 2017 in the Department of Hepatobiliary Surgery,the First Affiliated Hospital of Xi’an Jiaotong University.They performed ICG clearance tests,biochemical markers related to liver function tests,and Child-Pugh classification to assess liver reserve function before surgery.the patients were divided into two groups: A and B,according to the preoperative ICGR-15 measurement;The patients were also divided into two groups: a and b,according to Child-Pugh A and B level,and the Child-Pugh class A patients were divided into two groups:α and β.they were also divided into two groups: liver function compensation group and liver function compensation group according to postoperative liver function recovery.The relationship between the ICG clearance test(ICGR-15)and the Child-Pugh classification was evaluated after the operation,and the relationship between the ICGR-15 value and the hepatectomy volume and the postoperative liver dysfunction was analyzed according to the liver volume group of the surgical hepatectomy.All the statistical analysis was carried out by SPSS17.0 statistics software.The average number of two samples was compared with t test.The measurement data were tested by x 2 test with bilateral alpha =0.05 as the test level,and the difference of P < 0.05 was statistically significant.Results: This study included 58 subjects.According to the preoperative ICGR-15 level in two groups(ICGR-15 < 10%,ICGR-15 > 10%),the incidence of liver dysfunction in two groups was 39.1%,91.7%,and two groups were statistically significant(P < 0.05).According to Child-Pugh classification,the patients were divided into class A and class B,According to the Child-Pugh classification,the patients were divided into two groups of class A and B,of which the ICGR-15 value of the patients in class A was(6.05 + 4.70)%,B ICGR-15 was(22.53 + 10.76)%,and the difference between the two groups was statistically significant(P <0.05).Further analysis was made of the patients with Child-Pugh A,Further analysis of 52 patients with Child-Pugh a,the incidence of hepatic dysfunction after operation in ICGR-15 <10%,ICGR-15 > 10% two was 37.8% and 85.7% respectively.The difference between the two groups was statistically significant(P < 0.05).Analysis of liver resection volume less than50% and greater than 50% patients found that liver dysfunction occurred 40.4% and 90.9%,respectively,the difference between the two groups was statistically significant(P < 0.05).In the study of liver resection volume less than 50%,the incidence of liver dysfunction in ICGR-15 < 10% and ICGR-15 > 10% was 22.9% and 91.7%,respectively.The difference between the two groups was statistically significant(P < 0.05).Conclusion: The test of ICG clearance can accurately reflect the liver reserve function,and it plays an important role in predicting the postoperative liver dysfunction and the range of surgical resection.