PREOPERATIVE PREDICTION OF POSTOPERATIVE RESERVE HEPATIC-FUNCTION FORLIVER SURGERY FOR HEPATOBILIARY, PANCREATIC-CANCER

To perform safer hepatic resection for hepatobiliary-pancreatic cancer , the possibility of preoperative prediction of postoperative reserve hepatic function was assessed using hepatobiliary scintigraphy. After intravenous administration of Tc-99m-pyridoxyl-5-methyltryptophan in 2 3 patients, the time-activity curves of region of interest over the he art and liver were generated, and peak and one-fourth clearance times were calculated, which were compared with biochemical data. The parame ters were significantly related to protein syntheses (prothrombine tim e and hepaplastin test) and indocyanine-green dye excretion, but not t o hepatobiliary enzymes. So we hypothesized 'when the curve left by su btracting the resected area from the whole liver was larger than one-t hird of the total liver curve, the surgery would be safe', which we ap plied to another eight patients, clarifying the hypothesis. Hepatobili ary scintigraphy can be a promising procedure in the assessment of par tial liver function, and the study will contribute to a safer liver su rgery.