Preoperative assessment of liver function
Preoperative assessment of liver function
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DOI：
10.1016/s0039-6109(03)00224-x
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发表时间：
2004-04-01
影响因子：
3.1
通讯作者：
Schneider, PD
中科院分区：
文献类型：
--
作者：
Schneider, PD
根据 Child-Pugh 评分的测定、吲哚菁绿 (ICG) 保留测试以及对共存肝病程度的专业评估，选择 Child A 级患者，限制了肝切除术后因肝衰竭而导致的死亡。通过调整切除范围以满足足够切除边缘的需要，并在切除后维持足够的功能储备，术后发病率和死亡率将得到优化。使用 99m-Tc-半乳糖基人血清白蛋白的新功能闪烁扫描测试可能会增强未来的临床决策。鉴于目前肝切除患者选择的优异结果，该药物的未来研究必须关注大量切除患者的临床结果。
Deaths from hepatic failure after liver resection have been limited by selecting Child Class A patients, based on a determination of Child-Pugh scores, indocyanine green (ICG) retention testing, and knowledgeable assessment of the degree of coexisting liver disease. By adjusting the extent of resection to the concomitant need for an adequate resection margin, and maintenance of an adequate functional reserve after resection, postoperative morbidity and mortality will be optimized. A new functional scintigraphy test using 99m-Tc-galactosyl human serum albumin may augment clinical decision making in the future. In view of current excellent results with patient selection for hepatic resection, future studies of this agent must focus on clinical outcomes in a large number of resected patients.