The Operative Results for Esophagectomized Patients with Hepatic Dysfunction -Analysis by Using Indocyanine Green Excretion after 15 Minutes Test-

Junji Ohta, Hiromasa Fujita, Taizou Minami, Genzan Shirouzu, Hideaki Yamana, Teruo Kakegawa

First Department of Surgery, Kurume University School of Medicine

The operative results are poor for esophagectomized patients with severe hepatic dysfunction. In order to evaluate the efficasy of Indocyanine Green Excretion after 15 minutes test (R15ICG) as an indicator of preoperative risk, R15ICG was compared according to operative procedure, postoperative complications and operative results in 40 patients who underwent resection of carcinoma in the thoracic esophagus and whose R15ICG were more than 15%. The patients were divided into three groups by R15ICG: 21 in group A, from 15% to 19%; 10 in group B, from 20% to 24%; and 9 in group C,25% or more. Postopertive complications such as postoperative bleeding, anastomotic leakage, pyothorax, sepsis and others were found in 71% of the patients in group A, 80% of the patients in group B, and 100% of the patients in group C. Hospital mortality and operative death within 30 days were frequent in patients in group B and C. In particular, all patients in group C, who underwent palliative esophagectomy, died of postoperative complications during the primary hospitalization. Therefore, we conclude that the operative procedure of esophagectomy should be modified to a simpler procedure for patients having R15ICG of 20% or more, and palliative esophagectomy should be avoided in patients having R15ICG of 25% or more.

Key words
esophageal cancer, indocyanine green excretion test, postoperative complication, hospital mortality

Reprint requests
Junji Ohta First Department of Surgery, Kurume University School of Medicine
67 Asahi-machi, Kurume, 830 JAPAN

Accepted
January 8, 1992

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