ABOUT THE LIVER FUNCTIONAL RESERVE

Aim. Combined evaluation of liver functional and volumetric reserves prior to advanced liver resections. Material and Methods. The study included 24 patients who underwent extended liver resections for the period 2013– 2016. Clinical and laboratory data, indocyanine green (ICG) clearance, CT volumetry, static polypositional hepatoscintigraphy were assessed in all cases. Results. Individual tests showed sufficient functional reserve of FLR in all patients. However in 7 (29.2%) cases advanced resections were refused in favor of less liver volume removal, two-stage surgery or portal vein embolization to increase remnant liver volume. The reasons for refusal were compiled simulation of extended resection using PET combined with scintigraphy and comprehensive analysis of all factors affecting postoperative liver failure. Conclusion. Comprehensive assessment of functional and volumetric reserve prevents postoperative liver failure. At present time transition from evaluation of total liver parenchyma reserves to isolated assessment of FLR reserve is the most actual problem.

liver, functional reserve, liver failure, resection, CT volumetry, scintigraphy, indocyanine green

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