Liver regeneration after extended right hemihepatectomy in patients with hilar or diffuse bile duct carcinoma.

BACKGROUND/AIMS: The degree to which liver size can be restored and the factors that determine liver regeneration after major hepatectomy are not well understood.

METHODOLOGY: Liver volumes (LV) were estimated from computed tomography scans in 16 patients who survived with no evidence of cancer recurrence more than 1 year after extended right hemihepatectomy.

RESULTS

The mean percentage of LV at 1 year was 75.7 +/- 9.5% and LV did not change significantly beyond 1 year after surgery. A significant correlation was observed between LV at 1 year and body surface area (r = 0.79, p < 0.001). A significant inverse correlation was observed between LV at 1 year and the plasma retention rate of indocyanine green at 15 min (the ICG 15 value) (r = -0.72, p < 0.01).

CONCLUSIONS

In adults, the liver does not always regain its pre-operative size after hepatectomy. Patients' body size and intrinsic liver function or liver blood flow, represented by the ICG 15 value, may be related to regenerated liver size.