Determination of the extent of feasible hepatic resection from hepatic blood flow

Abstract

Abstract Blood flow in the residual liver after major hepatectomy is considered an important determinant factor of liver function. Presented here is a method of obtaining the whole and regional hepatic blood flow index from hepatic clearance of 198 Au‐colloid, which can predict the blood flow index of residual liver before operation and thereby prevent postoperative hepatic failure due to too large a resection. Hepatic resection was followed by a decrease of the hepatic blood flow index (K LAu ) almost proportional to the amount of hepatic mass resected. An analysis of data from 34 patients who underwent hepatectomy showed that the preoperatively predicted value of the blood flow index in the unresected liver had a good correlation ( r =0.9) with that measured 1 month after hepatectomy. It also correlated well with the risk of death from liver failure among those patients whose K L value of residual liver was under the critical level. Since 1981 the early death rate from liver failure after hepatectomy was reduced remarkably by preparing the resection boundary on the basis of the blood flow index of residual liver. With the use of our method in animal experiments, the hepatic blood flow index was found to be uninfluenced by reticuloendothelial system function and was considered to be a reliable indicator of blood flow in hepatic sinusoids .