Hepatectomy and marked retention of indocyanine green and bromosulfophtalein

A 61-year-old man was admitted to our hospital with right lateral abdominal pain. The patient had chronic hepatitis type B and type C and was diagnose d as hepatocellular carcinoma in the anterior-superior segment of the liver by ultrasonography and abdominal computed tomography. Although laboratory examinations were within normal limits, the indocyanine green retention rat e at 15min was as high as 72.0% and the bromosulfophtalein retention rate a t 45min 17.3%. We additionally performed technetium-99m-galactosyl human se rum albumin liver scintigraphy and liver biopsy, both of which indicated on ly mild chronic liver damage, indicating that the liver function is adequat e for surgery. After partial hepatectomy, a pathological examination reveal ed well to moderately differentiated hepatocellular carcinoma with only mil d chronic inflammation in adjacent liver tissue. The indocyanine green rete ntion rate at 15min is the best discriminating preoperative test for evalua ting hepatic functional reserve, but when marked retention of both indocyan ine green and bromosulfophtalein show the discrepancy with normal routine l iver function tests, technetium-99m-galactosyl human serum albumin liver sc intigraphy and liver biopsy are helpful diagnostic methods for assessing th e preoperative hepatic function.