Preoperative estimation of splenectomy and devascularization with indocyanine green test

Abstract

Objective To discuss the clinical value of indocyanine green(ICG) test in the evaluation of splenectomy and devascularization.Methods All the 50 patients with cirrhotic portal hypertension were analyzed for ICG,alanine transaminase (ALT),total bilirubin (TBIL) and albumin (ALB).Results The patients of Child A were stratified into the retention rate of indocyanine green 15 min(ICGR15) ＜ 20％group and ICGR15 ＞20％ group,and after operation,ALT levels (U/L) were at 1st day:40.54 ± 15.76 vs.46.33 ±14.19; 3rd day:29.29 ± 11.85 vs.49.83 ± 15.16; 7th day:21.04 ± 6.81 vs.32.67 ± 1.75 ; 12th day:15.21 ± 4.43 vs.18.00 ± 2.37,TBIL levels (μmol/L) at 1 st day:20.45 ± 7.86vs.30.77 ± 3.48 ; 3rd day:16.41 ± 6.71 vs.46.37 ± 11.26 ; 7th day:13.94 ± 5.02 vs.32.17 ± 10.52 ; 12th day:11.02±4.11 vs.19.65 ±3.90,and ALB levels (g/L) at 1st day:31.8 ±5.37 vs.30.45 ± 4.08; 3rd day:33.16 ± 3.05 vs.33.78 ±2.10; 7th day:31.17 ± 3.19 vs.29.33 ± 1.36; 12th day:30.51 ± 5.04 vs.26.35 ± 2.43.There were significant differences (all P ＜ 0.05).The prognosis of patients with ICGR15 ＜20％ was more satisfactory than in those with ICGR15 ＞20％.Conclusion ICG test can be used to evaluate the liver functions of patients receiving splenectomy and devascularization,and is the beneficial supplement to Child-Pugh grade. Key words: Cirrhotic portal hypertension; Indocyanine green test; Splenectomy and devascularization