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Medical AI Inquiry: You was designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.  Labels: BACKGROUND, METHODS, RESULTS. Meshes: Adult, Aged, Aged, 80 and over, Female, Hepatectomy, Hepatocytes, Humans, Hyperbilirubinemia, Indocyanine Green, Liver, Liver Failure, Male, Metabolic Clearance Rate, Middle Aged, Preoperative Care, Radiopharmaceuticals, Retrospective Studies, Technetium Tc 99m Aggregated Albumin, Tomography, Emission-Computed, Single-Photon.
user
Is preoperative regional maximal removal rate of technetium-99m-galactosyl human serum albumin ( GSA-Rmax ) useful for judging the safety of hepatic resection? Context: For hepatic resection, the preoperative estimation of hepatic functional reserve in the predicted remnant liver may be more important than that of the entire liver. We evaluated the maximal removal rate of technetium-99m-galactosyl-human serum albumin (GSA-Rmax) in the remnant. One hundred and seventy-eight patients were admitted for elective hepatectomy. Conventional liver function, and 15-minute retention rate of indocyanine green (ICGR15) were carried out preoperatively. The GSA-Rmax was calculated according to a radiopharmacokinetic model; then we used the single photon emission computed tomography images to calculate the regional GSA-Rmax in the predicted residual liver (GSA-RL), depending on the operative procedures. The volume of the predicted residual liver (LV-RL) was calculated on the basis of computed tomography images. The preoperative LV-RL correlated well with the GSA-RL in patients with normal liver; however, there was no such correlation in those with chronic hepatitis or cirrhosis. All of 7 postoperative hyperbilirubinemia occurred in the patients with GSA-RL < 0.15. Two patients died of postoperative liver failure 1 to 2 months after the operation. These 2 patients had GSA-RL values of 0.078 and 0.090, respectively, and severe discrepancies between the GSA-Rmax in the remnant liver and ICGR15.
assistant
We concluded that GSA-RL may be useful for determining the procedure of hepatectomy and that the value should be maintained at greater than 0.15 to avoid postoperative hyperbilirubinemia or hepatic failure. Final Decision: yes