A Surgical Case of Hepatocellular Carcinoma Associated with Constitutional Indocyanine Green Excretory Defect

Yukoh Kin, Akihiro Yamaguchi, Masatoshi Isogai, Akihiro Hori

Department of Surgery, Ogaki Municipal Hospital

A surgical case of hepatocellular carcinoma associated with marked retention on the ICG test (retention rate at 15 min, 70%) is reported. Since laboratory data except for the ICG test were normal, the patient was diagnosed with constitutional ICG excretory defect. To estimate preoperative liver function, we performed two further exainations. One was laparoscopic observation of the liver with subsequent non-tumorous liver biopsy, which showed chronic active hepatitis. The other was intrahepatic blood flow assessment using color Doppler ultrasound, which demonstrated normal flow paterns. During surgery, we measured the arterial blood ketone body ratio under hemihepatic vascular occlusion, and judging from the results of these examinations, left hepatic lobectomy was done followed without any postoperative trouble. Since to decide extent of hepatectomy is difficult in the case with the ICG excretory defect, more experience with this disorder and new techniques for evaluating liver functional reserve might be necessary.

Key words
constitutional Indocyanine green excretory defect, hepatocellular carcinoma, left hepatic, lobectomy

Reprint requests
Yukoh Kin Department of Surgrey,Ogaki Municipal Hospital
4-86 Minaminokawa-cho, Ogaki, 503 JAPAN

Accepted
October 12, 1994

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