Hepatobiliary scintigraphy for risk assessment of posthepatctomy liver failure

Abstract

Background: Aims of the study:. 1) to assess the role of hepatobiliary scintigraphy for prognosis of hepatic failure after liver resection. 2) to determine the borderline index of hepatic uptake (IHU) of radioactive agent as an indication for surgical prophylactic of hepatic failure. Methods: Ninety nine patients were investigated by hepatobiliy scintigraphy for different liver diseases and liver tumors(2015-2016 year):. 1) 50 patients from hepatology department with liver biopsy(METAVIR assessment) because of different liver disorders (chronic hepatitis, liver cirrhosis). 2) 49 patients underwent major liver resections (more than 3 segments) for liver tumors. Results: The mean value of IHU of 2,86 was revealed in patients with liver fibrosis F1, and IHU of 2,02 was identified in patients with liver fibrosis F4. Bordeline mean value of IHU made up of 2,4. In 18 patients with IHU<2,4 and remnant liver <40% surgical prophylactic of hepatic failure was performed: ligation of portal vein(1), portal embolization (12), percutaneous embolization of the right portal vein with radiofrequency ablation along the plane of future liver transaction (5). The increase of index of hepatic uptake up to 2.7±0.47 was revealed in future remnant liver in 14-21 days after devascularization. Conclusion: Dynamic hepatobiliaryscintigraphy is valuable in assessment of volume and function of different areas of liver. IHU of 2.4 and volume of the future remnant liver <40% are the indication for surgical prevention of postresectionliver failure.