Objective Assessment of Hepatic Pathology by Computer Simulation

Kenji Sakurai

First Department of Surgery, Jikei University School of Medicine

Precise assessment of morphological and functional pathologies of the liver is required during the perioperative period of hepatectomy, which results in massive liver mass reduction, and/or the period of any operative procedure in patients with advanced liver disease. For objective and quantitative assessments of the hepatic pathologies, 1) kinetic behavior of indocyanine green (ICG) injected into circulation, and 2) three dimensional images of the liver were analyzed. It was feasible to estimate the ICG excretion parameters including liver function and circulating blood volume. The three dimensional images led me to attain regional liver volume, localization of tumors, volumetric hepatic tumor ratio, posthepatectomy regeneration modes, and to help surgeons decide optimal resectional plane and procedure by computer simulation. Hepatic pathology should not be appreciated independently based on either morphologic or functional tests. Generalized comprehension of results obtained by both tests and computer simulation is imperative for objective assessment of hepatic pathology. It would be valuable for accurate estimation of the hepatic reserve in postoperative period of preplanned certain procedure.

Key words
kinetic behavior of indocyanine green, three dimensional image of the liver, estimation of hepatic functional reserve by computer simulation

Reprint requests
Kenji Sakurai First Department of Surgery, Jikei University School of Medicine
3-25-8 Nishi-Shinbashi, Minato-ku, Tokyo, 105 JAPAN

Accepted
December 9, 1992

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