Abstract
In our institution, an index; ICG Krem (multiplication of disappearance rate of indocyanine green and remnant liver volume ratio to total liver volume) has been adopted for indication of hepatectomy. In the present study, clinical usefulness and limitation of this index in patients with hilar cholangiocarcinoma was assessed retrospectively with a prospectively collected database. Forty-six consecutive patients with hilar cholangiocarcinoma were enrolled in this study, and conformity with ICG Krem and previously reported indices, morbidity, and mortality were evaluated. The conformity rate with ICG Krem was 82.6%, and those with Makuuchi's decision tree and Hyogo University index (≥50 points) were 54.3% and 45.7% respectively with lower congruity. Morbidity and mortality rates of our series were 45.7% and 2.2% (1 patient), respectively. Liver insufficiency was not observed. In 8 deviated cases (17.4%) from our index, hepatectomies were indicated after portal vein emblization of the affected lobe with special consideration to remnant liver volume (minimum, 278mL), remnant ratio (29%), remnant liver volume ratio to body weight (0.54% v/w), and status of biliary obstruction.
