Factors Influencing Hepatic Functional Reserve after Hepatectomy for Primary Liver Cancer

Objective To investigate the factors influencing hepatic functional reserve after hepatectomy for primary liver cancer.Methods Clinical data of 272 patients who underwent hepatectomy for hepatocellular carcinoma were analyzed retrospectively.Indicators included age,gender,diabetes,HBsAg,tumor size,single/multiple tumor types,extent of surgical resection,alanine aminotransferase,aspartate aminotransferase,alkaline phosphatase,prealbumin,albumin,total protein,total bilirubin,direct bilirubin,γ-glutamyltranspetidase,cholinesterase,lactate dehydrogenase,total bile acid,prothrombin time and platelet count.Results High levels of γ-glutamyltranspetidase were the independent risk factor for decompensation of liver function.ROC curve analysis showed that the cut-off value of preoperativeγ-glutamyltranspetidase for predicting postoperative hepatic decompensation was 168 U·L-1(sensitivity:72.7%,specificity: 90.0%).The incidence of postoperative hepatic decompen-sation was 63.6% when γ-glutamyltranspetidase concentrations were greater than or equal to 168 U·L-1.Conclusion Hepatocellular carcinoma patients with 15-minute indocyanine green clearance rate less than 15% and γ-glutamyltranspetidase concentrations less than 168 U·L-1 had good postoperative recovery of liver function.Therefore,preoperative monitoring of γ-glutamyltranspetidase level and 15-minute indocyanine green clearance rate is useful for comprehensively evaluating the compensation of liver function.