Evaluation of Liver Function by Indocyanine Green in Patients with Obstructive Jaundice -Usefullness of Heavy ICG Load Test-

Ken-ichi Kumazawa, Toshinori Oishi, Seiji Ohigashi, Koichi Kubota, Yoshiaki Asami, Yoichi Otani, Shunsuke Haga, Tetsuro Kajiwara

Department of Surgery, Tokyo Women's Medical College, Daini Hospital

In order to evaluate the indocyanine green (ICG) test for patients with obstructive jaundice, 183 inpatients who had undergone an ICG test during the past 9 years were divided into 105 individuals with liver cirrhosis, 35 with jaundice and 43 without jaundice, and their data were compared. The disappearance rates (K_0.5, K_3.0) at ICG doses of 0.5 and 3.0 mg/kg and the maximum removal rate (Rmax) were obtained, and the correlation between Rmax and each disappearance rate was examined. In the cirrhosis group, Rmax was strongly correlated with both K_0.5 and K_3.0, showing correlation co-efficients of 0.724 and 0.869, respectively. In contrast, in thejaundice and non-jaundice groups, Rmax was strongly correlated with K_3.0 (0.832, 0.791), but there was a wide variance in the values of K_0.5 (0.525,0.524). In addition, the gradient of the regression line for the correlation with K_0.5 was moderate, 0.392, in the jaundice group, whereas it was 0.799 in the cirrhosis group. Of 26 patients who underwent resection of two or more hepatic segments, 11 had a total bilirubin level of 10 mg/dl or higher during surgery. In these 11 patients, Rmax and K_3.0 were low before surgery, but the preoperative K_0.5 varied widely. Thus, Rmax proved to be a superior parameter of the preoperative ICG test for patients with obstructive jaundice. With regard to the disappearance rate, K_3.0 under a greater load was found to reflect the degree of hepatic reserve more faithfully.

Key words
preoperative evaluation of hepatic function in obstructive jaundice, tolerance test of indocyanine green

Reprint requests
Ken-ichi Kumazawa Department of Surgery, Tokyo Women's Medical College, Daini Hospital
2-l-10 Nishi-Oku, Arakawa, Tokyo, 116 JAPAN

Accepted
May 13, 1992

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