Clinical study of standard residual liver volume and transient elastography in predicting poor prognosis of patients after hemihepatectomy

Table 1 The new liver reserve assessment model

Score	1	2	3
HE	No	1-2	3-4
ABD	No	Mild	Moderate to severe
TIBL (μmol/L)	< 34	34-51	> 51
ALB (g/L)	> 35	28-35	> 28
Prothrombin Time (secprolonged)	< 15	15-17	> 17
LSM (kPa)	< 15	15-25	> 25

Note-scoring criteria: A score less than 9 = grade I; a score between 9 and 12 = grade II; a score greater than 12 = grade III. HE: Hepatic encephalopathy; ABD: Abdominal dropsy; TIBL: Total bilirubin; ALB: Albumin; LSM: Liver stiffness measure.

Table 2 Comparison of the clinical features of the surgical safety group and liver dysfunction group (mean ± SD)

Variables	Total	Postoperative liver function		P value
		No liver dysfunction	Liver dysfunction
Sex
Male	19	12	7	1.000
Female	16	11	5
Age (yr)
< 60	20	14	6	0.721
≥ 60	15	9	6
BMI
< 24 kg/m2	21	13	8	0.721
> 24 kg/m2	14	10	4
BSA (m2)		1.71 ± 0.18	1.75 ± 0.16	0.514
WBC (× 109/L)		5.51 ± 2.39	5.19 ± 1.55	0.672
RBC (1012/L)		4.30 ± 0.65	4.61 ± 0.44	0.146
PLT (× 109/L)		126.17 ± 53.74	149.33 ± 79.83	0.314
ALB (g/L)		40.71 ± 4.23	39.63 ± 4.18	0.478
Scr (μmol/L)		76.98 ± 39.07	64.87 ± 10.63	0.303
ALT [U/L, M (QR)]		67.26 ± 94.41	46.58 ± 30.40	0.468
AST [U/L, M (QR)]		45.61 ± 23.63	58.00 ± 68.68	0.436
TB [umol/L, M (QR)]		15.63 ± 7.20	20.99 ± 8.36	0.056
GGT [U/L, M (QR)]		115.17 ± 112.78	124.00 ± 145.78	0.844
AFP [ng/mL, M (QR)]		9999.23 ± 25773.40	8545.66 ± 15372.77	0.859
PIVKA-II [μg/L, M (QR)]		1799.54 ± 5017.78	3574.73 ± 6543.79	0.378
PT (s)		12.59 ± 1.46	12.39 ± 1.04	0.682
INR (s)		1.10 ± 0.12	1.05 ± 0.11	0.227
LSM value (kPa)		20.34 ± 4.89	25.78 ± 5.38	0.005a
ICG R15 (%)		7.99 ± 5.13	11.96 ± 6.43	0.055
SRLV (L/m2)		0.349 ± 0.075	0.276 ± 0.036	0.003a
Tumor-localizing
Left half liver	15	10	5	1.000
Right half liver	20	13	7
Tumor diameter [cm, M (QR)]		6.63 ± 3.86	7.81 ± 4.91	0.436
Time of hepatic portal occlusion [min, M (QR)]		14.65 ± 19.42	15.75 ± 14.10	0.864
Intraoperative bleeding [mL, M (QR)]		908.70 ± 818.76	1541.67 ± 1612.57	0.130
Operation time (min)		176.30 ± 49.98	185.83 ± 72.89	0.651

^aP < 0.01 vs group of safe operation (no liver dysfunction) and liver dysfunction. PIVKA-II was abnormal prothrombin. BMI: Body mass index; BSA: Body surface area; WBC: White blood cell; RBC: Red blood cell; PLT: Platelet; ALB: Albumin; ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; TB: Total bilirubin; GGT: γ-glutamyl transpeptidase; AFP: Alpha fetoprotein; PT: Prothrombin time; INR: International normalized ratio; LSM: Liver stiffness measure; ICG: Indocyanine green; SRLV: Standard residual liver volume.

Table 3 Logistic regression analysis based on preoperative the liver stiffness measure value and standard residual liver volume

Independent variables	P value	OR	95%CI
LSM ≥ 25 kPa	0.032	6.254	1.172-33.374
SRLV ≤ 290 ML/m2	0.048	5.686	1.017-31.793

OR: Odds ratio; CI: Confidence interval; LSM: Liver stiffness measure; SRLV: Standard residual liver volume.

Table 4 The standard residual liver volume of different stages of liver fibrosis in 35 patients after hemihepatectomy (mean ± SD)

Liver fibrosis stage	Number	SRLV (L/m2)	F value	P value
S1	6	289.43 ± 22.36	8.164	0.001
S2-S3	15	290.33 ± 56.70
S4	14	375.53 ± 72.24

SRLV: Standard residual liver volume.

Table 5 The standard residual liver volume of different liver fibrosis stages in 12 patients with liver insufficiency after hemihepatectomy

Liver fibrosis stage	Number	SRLV (L/m2)	F value	P value
S1	1	234.20	4.768	0.039
S2-S3	7	263.14 ± 31.28
S4	4	308.98 ± 18.02

SRLV: Standard residual liver volume.

Table 6 The comparison of two assessment methods, n (%)

Model	Total	Grade	Number	Grade 3 wk after surgery (cases)
				A (I)	B (II)	C (III)
Child-Pugh score	35	A	31	17 (54.8)	14 (45.2)	0
		B	4	0	1 (25)	3 (75)
		C	0	0	0	0
The new evaluation model	35	I	11	11 (100)a	0	0
		II	23	0	21 (91.3)b	2 (18.7)
		III	1	0	0	1

^aP < 0.05 vs new evaluation model grade I and Child-Pugh grade A.

^bP < 0.05 vs new evaluation model grade II and Child-Pugh grade B.