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AIM: To assess the validity of our selection criteria for hepatectomy procedures based on indocyanine green disappearance rate (K_(ICG)), and to unveil the factors affecting posthepatectomy mortality in patients with hepatocellular carcinoma (HCC). METHODS: A retrospective analysis of 198 consecutive patients with HCC who underwent partial hepatectomies in the past 14 years was conducted. The selection criteria for hepatectomy procedures during the study period were K_(ICG)≥0.12 for hemihepatectomy, K_(ICG)≥0.10 for bisegmentectomy, K_(ICG)≥0.08 for monosegmentectomy, and K_(ICG)≥0.06 for nonanatomic hepatectomy. The hepatectomies were categorized into three types: major hepatectomy (hemihepatectomy or a more extensive procedure), bisegmentectomy, and limited hepatectomy, Univariate (Fisher’s exact test) and multivariate (the logistic regression model) analyses were used. RESULTS: Postoperative mortality was 5% after major hepatectomy, 3% after bisegmentectomy, and 3% after limited hepatectomy. The three percentages were comparable (P=0.876). The platelet count of ≤10×10~4/μL was the strongest independent factor for postoperative mortality on univariate (P=0.001) and multivariate (risk ratio, 12.5; P=0.029) analyses. No patient with a platelet count of >7.3×10~4/μL died of postoperative morbidity, whereas 25% (6/24 patients) of patients with a platelet count of ≤7.3×10~4/μL died (P<0.001). CONCLUSION: The selection criteria for hepatectomy procedures based on K_(ICG) are generally considered valid, because of the acceptable morbidity and mortality with these criteria. The preoperative platelet count independently affects morbidity and mortality after hepatectomy, suggesting that a combination of K_(ICG) and platelet count would further reduce postoperative mortality.
AIM: To assess the validity of our selection criteria for hepatectomy procedures based on indocyanine green disappearance rate (K_ (ICG)), and to unveil the factors affecting posthepatectomy mortality in patients with hepatocellular carcinoma (HCC). METHODS: A retrospective analysis of 198 consecutive patients with HCC who underwent partial hepatectomies in the past 14 years were conducted. The selection criteria for hepatectomy procedures during the study period were K_ (ICG) ≥ 0.12 for hemihepatectomy, K_ (ICG) ≥0.10 for bisegmentectomy, K_ (ICG) ≥ 0.08 for monosegmentectomy, and K_ (ICG) ≧ 0.06 for nonanatomic hepatectomy. The hepatectomies were categorized into three types: major hepatectomy (hemihepatectomy or a more extensive procedure), bisegmentectomy, and limited hepatectomy, Univariate (Fisher’s exact test) and multivariate RESULTS: Postoperative mortality was 5% after major hepatectomy, 3% after bisegmentectomy, and 3% after lim The platelet count of ≤10 × 10 ~ 4 / μL was the strongest independent factor for postoperative mortality on univariate (P = 0.001) and multivariate (risk ratio, 12.5; P = 0.029) analyzed. No patient with a platelet count of> 7.3 × 10 ~ 4 / μL died of postoperative morbidity, while 25% (6/24 patients) of patients with a platelet count of ≤ 7.3 × 10 ~ 4 / μL died (P <0.001) CONCLUSION: The selection criteria for hepatectomy procedures based on K_ (ICG) are generally considered valid, because of the acceptable morbidity and mortality with these criteria. The preoperative platelet count secondary affects morbidity and mortality after hepatectomy, suggesting that a combination of K_ (ICG) and platelet count would further reduce postoperative mortality.