Decreased mebrofenin uptake in patients with non-colorectal liver tumors requiring liver volume augmentation-a single-center analysis

Langenbecks Arch Surg. 2024 Mar 11;409(1):92. doi: 10.1007/s00423-024-03280-5.

Abstract

Background: Posthepatectomy liver failure (PHLF) remains a life-threatening complication after hepatectomy. To reduce PHLF, a preoperative assessment of liver function is indispensable. For this purpose, 99mTc-mebrofenin hepatobiliary scintigraphy with SPECT (MSPECT) can be used. The aim of the current study was to evaluate the predictive value of MSPECT for PHLF in patients with non-colorectal liver tumors (NCRLT) compared to patients with colorectal liver metastasis (CRLM) undergoing extended liver resection.

Methods: We included all patients undergoing extended liver resections via two-stage procedures between January 2019 and December 2021 at the University Medical Center Hamburg-Eppendorf, Germany. All patients received a preoperative MSPECT.

Results: Twenty patients were included. In every fourth patient, PHLF was observed. Four patients had PHLF grade C. There were no differences between patients with CRLM and NCRLT regarding PHLF rate and future liver remnant (FLR) volume. Patients with CRLM had higher mebrofenin uptake in the FLR compared to those with NCRLT (2.49%/min/m2 vs. 1.51%/min/m2; p = 0.004).

Conclusion: Mebrofenin uptake in patients with NCRLT was lower compared to those patients with CRLM. However, there was no difference in the PHLF rate and FLR volume. Cut-off values for the mebrofenin uptake might need adjustments for different surgical indications, surgical procedures, and underlying diseases.

Keywords: Extended liver resection; Hepatobiliary scintigraphy; Liver augmentation; PHLF.

MeSH terms

  • Aniline Compounds*
  • Colorectal Neoplasms* / complications
  • Colorectal Neoplasms* / diagnostic imaging
  • Colorectal Neoplasms* / surgery
  • Glycine*
  • Hepatectomy / adverse effects
  • Humans
  • Liver / diagnostic imaging
  • Liver / surgery
  • Liver Failure* / etiology
  • Liver Neoplasms* / diagnostic imaging
  • Liver Neoplasms* / surgery
  • Postoperative Complications
  • Radiopharmaceuticals
  • Retrospective Studies

Substances

  • mebrofenin
  • Radiopharmaceuticals
  • Aniline Compounds
  • Glycine