Abstract
Formerly, standard hepatobiliary functional reserve of each hepatic lobe before hepatectomy has not proved to be of substantive prognostic value in patient having invasion of cancer to the hilar ducts and undergoing biliary decompression for obstructive jaundice. To evaluate usefulness of ICG Bmax in hepatectomy bigger than lateral segmentectomy, the 13 hepatectomized patients who underwent unilobar or bilobar biliary decompression as a result of hilar carcinoma were studied. Correlations between ICG Bmax values and other blood chemistry values were evaluated. Two of the three patients with ICG Bmax values of remaining hepatic lobe below 0 were died of liver failure. The remaining one had complications such as intractable pleural effusion and prolonged hyperbilirubinaemia. In the seven patients with complications ICG Bmax values showed below 0.5. The morbidity in seven patients with ICG Bmax values between 0 and 0.5 was 57 %. In patients showing ICG Bmax values below 0, hepatectomy bigger than segmentectomy is contraindicated despite intensive postoperative care. The present study showed that the ICG Bmax test may be a useful and reliable indicator of prognosis in hepatectomy after biliary decompression for obstructive jaundice as a result of hilar carcinoma.
