Liver regeneration and restoration of liver function after partial hepatectomy: the relation of fibrosis of the liver parenchyma

• Published in: Hepato-gastroenterology Vol. 46; no. 29; p. 2919
• Main Authors: Miyazaki, S, Takasaki, K, Yamamoto, M, Tsugita, M, Otsubo, T
• Format: Journal Article
• Language: English
• Published: Greece 01-09-1999
• Subjects: Adult; Aged; Female; Hepatectomy; Humans; Indocyanine Green; Liver - diagnostic imaging; Liver - pathology; Liver Cirrhosis - diagnostic imaging; Liver Cirrhosis - pathology; Liver Function Tests; Liver Neoplasms - surgery; Liver Regeneration - physiology; Male; Middle Aged; Postoperative Complications - diagnostic imaging; Postoperative Complications - pathology; Tomography, X-Ray Computed
• ISSN: 0172-6390

Patients who survive partial hepatectomy sometimes have unsatisfactory liver regeneration and restoration of liver function. Although the extent of resection should be adjusted to attain favorable liver regeneration and restoration of liver function, a guiding principle for this has not been established.
Seventy patients with hepatic tumors associated with liver disorders of various severity who underwent hepatectomy were studied. We calculated the removal rate of the liver and the regeneration rate of the remnant liver using computed tomography. The liver function was investigated using ICG R-15 (retention rate of indocyanine green). Liver disorder was classified into 4 groups, according to the severity of fibrosis.
The regeneration rates of the remnant liver indicated a significant decline in patients with severe fibrosis. In the no fibrosis and mild fibrosis groups, an increased removal rate was associated with increased regeneration rate, and post-operative ICG R-15 improved with time. However, in the moderate fibrosis and severe fibrosis groups, an increased removal rate was not associated with increased regeneration rate, and post-operative ICG R-15 showed no change or became worse with time.
Severe fibrosis of the liver parenchyma is associated with poorer regeneration of the remnant liver leading to poor restoration of post-operative liver function. The severity of fibrosis is useful as a predictive factor for liver regeneration and restoration of liver function after partial hepatectomy.