Safe Threshold Rate of Indocyanine Green Retention and Intervention of Nutrition Management After Hepatectomy.

IF 2 4区医学 Q3 NUTRITION & DIETETICS Nutrition and Cancer-An International Journal Pub Date : 2024-11-21 DOI:10.1080/01635581.2024.2431348

Junping Gao, Zhan Lu, Wanqiang Liang, Jie Zhang, Shangdong Qin, Juntao Huang, Wenfeng Gong, Bangde Xiang

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Abstract

Objective: This study investigated the safe indocyanine green retention rate at the 15-minute (ICG-R15) threshold for hepatectomy and the effect of nutritional management on ICG-R15 and posthepatectomy liver failure (PHLF).

Methods: A retrospective cohort study was conducted on 70 hepatectomy patients with chronic liver disease, divided into routine care and nutrition intervention groups. ICG-R15 was measured pre- and postoperatively, along with PHLF occurrence and other health metrics.

Results: Seventy patients with chronic liver disease were divided into two groups: one received routine care, while the other followed a nutrition plan based on Omaha theory. The intervention group showed a significantly lower incidence of PHLF (15.8% vs 41.2%, p = 0.009) and clinically relevant PHLF (5.3% vs 19.6%, p = 0.031), along with shorter hospital stays (11.3 ± 6.4 days vs 21.5 ± 15.5 days, p = 0.012) and fewer complications (26.3% vs 47.1%, p = 0.020). The optimal ICG-R15 threshold for predicting PHLF was 4.5%, with 8.5% being critical.

Conclusion: ICG-R15 is a reliable predictor of PHLF, with 4.5% being safe and 8.5% critical. Nutritional management based on Omaha theory improves outcomes and quality of life. Further validation is needed.

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肝切除术后吲哚菁绿潴留的安全阈值率和营养管理干预。

研究目的本研究探讨了肝切除术 15 分钟（ICG-R15）阈值的安全吲哚菁绿保留率，以及营养管理对 ICG-R15 和肝切除术后肝衰竭（PHLF）的影响：对70名慢性肝病肝切除术患者进行了一项回顾性队列研究，分为常规护理组和营养干预组。结果：70 名慢性肝病肝切除术患者分为常规护理组和营养干预组，术前和术后测量 ICG-R15，同时测量 PHLF 发生率和其他健康指标：70名慢性肝病患者被分为两组：一组接受常规护理，另一组遵循基于奥马哈理论的营养计划。干预组的 PHLF 发生率（15.8% vs 41.2%，p = 0.009）和临床相关 PHLF 发生率（5.3% vs 19.6%，p = 0.031）明显降低，住院时间缩短（11.3 ± 6.4 天 vs 21.5 ± 15.5 天，p = 0.012），并发症减少（26.3% vs 47.1%，p = 0.020）。预测 PHLF 的最佳 ICG-R15 阈值为 4.5%，8.5% 为临界值：ICG-R15是预测PHLF的可靠指标，4.5%为安全值，8.5%为临界值。基于奥马哈理论的营养管理可改善预后和生活质量。需要进一步验证。

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来源期刊

Nutrition and Cancer-An International Journal 医学-营养学

CiteScore

5.80

自引率

3.40%

发文量

172

审稿时长

3 months

期刊介绍： This timely publication reports and reviews current findings on the effects of nutrition on the etiology, therapy, and prevention of cancer. Etiological issues include clinical and experimental research in nutrition, carcinogenesis, epidemiology, biochemistry, and molecular biology. Coverage of therapy focuses on research in clinical nutrition and oncology, dietetics, and bioengineering. Prevention approaches include public health recommendations, preventative medicine, behavior modification, education, functional foods, and agricultural and food production policies.