Assessment of Preoperative Liver Function for Surgical Decision Making in Patients with Hepatocellular Carcinoma

作者：Takashi Kokudo, Kiyoshi Hasegawa, Chikara Shirata, Meguri Tanimoto, Takeaki Ishizawa, Junichi Kaneko, Nobuhisa Akamatsu, Junichi Arita, Nicolas Demartines, Émilie Uldry, Norihiro Kokudo, Nermin Halkic · 发表于：Liver Cancer · 年份：2019 · DOI：10.1159/000501368 · 被引用次数：72 · 研究领域：Hepatocellular Carcinoma Treatment and Prognosis、Organ Transplantation Techniques and Outcomes、Liver Disease and Transplantation

BACKGROUND: Most patients with hepatocellular carcinoma (HCC) have underlying liver disease and a preoperative liver function evaluation is important to avoid postoperative liver failure and death. In Western guidelines, portal hypertension (PH) is listed as a contraindication for liver resection. On the other hand, the indocyanine green retention rate at 15 min (ICG R15) has been widely used in Asian countries for surgical decision making. However, these criteria are based on reports published in the 20th century that included only a small number of patients and were developed empirically. SUMMARY: The number of published case series concerning liver resection in HCC patients with PH has been rapidly increasing since 2011, indicating that liver resection in HCC patients with PH is now routinely performed in specialized centers worldwide. Although PH certainly has an impact and should be considered as a contraindication for major liver resection, it is no longer considered to be a contraindication for minor liver resection, especially laparoscopic liver resection. In addition, new biomarkers and imaging tools to assess preoperative liver function have been extensively reported. The combination of these new factors to well-known risk factors, such as PH and ICG R15, might strengthen the ability to stratify the risk of postoperative liver failure. KEY MESSAGES: The present review covers recent topics regarding the assessment of preoperative liver function for surgical decision ...