| Objective: To investigate the application of ICG-R15 grading,Child-Pugh grading and ALBI grading in liver function evaluation after partial hepatic resection for hepatic alveolar echinococcosis,and the predictive value of ICG-R15 in hepatic dysfunction after partial hepatic resection for hepatic alveolar echinococcosis.Methods: A retrospective analysis was conducted on 67 patients with hepatic alveolar echinococcosis who underwent partial liver resection from July 2020 to December 2021 in xx University Affiliated Hospital.All patients were treated with partial liver resection.The retention rate(ICG-R15)in 15 minutes was measured on day 3 and day 7 after surgery and compared with child-Pugh(C-P),albumin bilirubin(ALBI)and ICG-R15.And ICG-R15 prediction of hepatic insufficiency after partial liver resection.Results: A total of 67 patients undergoing partial liver resection were included in this study.On the third day after surgery,15 patients with hepatic alveolar echinococcosis developed hepatic insufficiency,and 52 patients with hepatic alveolar echinococcosis recovered well after surgery,accounting for 22.4% of the incidence of hepatic insufficiency.On the 7th day after partial liver resection,there were 9 patients with hepatic insufficiency after surgery,and 58 patients with hepatic cystic echinococcosis had mild liver function after liver resection,and the incidence of hepatic insufficiency was 13.4%.On the 3rd and 7th day after hepatic echinococcosis resection,ICG-R15 showed a statistical difference between the group with mild liver function and the group with hepatic insufficiency(P < 0.05).On the 3rd and 7th day after liver resection for hepatic alveolus echinococcosis,a comparison of grades showed that ICG-R15<10% was the largest in grade a of child-pugh grading A.which were larger than ICG-R15 10 ～ 20% and>20%.In grade B,ICG-R15 accounted for 10 ～ 20% of patients,and was larger than ICG-R15<10% and>20% of patients;the number of patients with ICG-R15 > 20% in grade C was the largest,which was larger than those with ICG-R15 < 10% and 10-20%.The child-Pugh GRADE A ratio of the ICG-R15<10% was larger than that of B and C;The proportion of Child-Pugh GRADE B in ICG-R15 10-20% is larger than that of A and C;The proportion of Child-pugh GRADE C in ICG-R15 > 20% is larger than that of A and B.ALBI Grade 1 the most patients were ICG-R15<10%,which were larger than ICG-R15 10 ～ 20% and 20%;in grade 2,ICG-R15 accounted for 10 ～ 20% of patients,and was larger than ICG-R15<10% and > 20% of patients;patients with ICG-R15 > 20% were the most in grade 3,which was larger than those with ICG-R15 < 10% and 10-20%.The ICG-R15<10% in ALBI Grade 1 accounted for more than grade 2 and 3.In ICG-R15 10-20% grading,ALBI grade 2accounted for more than grade 1 and 3;The proportion of ALBI grade 3 in ICG-R15 > 20% was higher than that of ALBI grade 1 and ALBI grade 2.The consequences of classification test showed P < 0.05,and the difference was statistically significant.The areas under ROC curve of hepatic insufficiency in ICG-R15 patients on day 3 and day 7 after hepatectomy were as follows: 0.83,0.88,when ICG-R15=3.65 on the third day after liver resection,the ICG-R15 area under the curve was the largest on the third day after liver resection for hepatic alveolus echinococcosis,and the sensitivity was 86.7%,and the specificity was 65.4%(when ICG-R15 =3.65 on the seventh day after liver resection,The sensitivity and specificity were 88.9% and 65.5% respectively.When ICGR15=3.95 on the 7th day after liver resection,the ICG-R15 area under the curve of hepatic alveolus echinococcosis patients was the largest,with a sensitivity of 88.9% and a specificity of 75.9%(when the ICG-R15=3.95 on the 3rd day after surgery,the sensitivity was 80.0%.Specificity was 69.2%).Conclusions:The ICG-R15 grading can reflect the postoperative reserve function of Hepatic alveolar echinococcosis.ICG-R15 can predict hepatic insufficiency on the 3rd and 7th day after Hepatic alveolar echinococcosis. |
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