Background and Goal of Study: Indocyanine green elimination by pulse spectrophotometry is a non-invasive liver function monitoring system. The aim of this study is to assess the relationship between postoperative ICG plasma disappearance rate (ICG PDR % min) and the onset of medical and surgical complications.

Materials and Methods:33 patients scheduled for mayor liver resection were selected. ICG PDR was measured preoperatively and on the day 1 and 2 postoperative. We recorded the appearance of surgical complications postoperatively (liver ischemia, biliary leak and intra-abdominal fluid collections and medical complications (pneumonia, ascites, pleural effusion, infection, coagulopathy and thrombosis) This study is registered in ClinicalTrials.gov under the number NCT02813538. This study was approved by the Ethics Committee. All the patients were included after signing an Informed Consent
Results and Discussion: 7 patients underwent surgical complications and 14 medical ones. When analyzing the surgical complications, PDR the first day was mayor in the group that did not develop any events 18,4 ± 6 against 11,3 ± 7 in the group with surgical issues (p 0,014) Regarding medical events, first day PDR was 19± 6 in the patients with no issues versus 13 ± 5 in the group that had any medical complication. Moreover, our results show a significative association between PDR measurement taken on postoperative day 1 and hospital stay (r = -0,46 p=0,01) and ICU stay (r=-0,37 p= 0,03). No significative association was found between routine laboratory tests and adverse events occurrence.

Conclusions: ICG PDR is a useful, non-invasive liver function test in patients undergoing major liver resection. It may help to predict both medical and surgical complications in these patients, improving their management and therefore, their outcome.

References:
1.	Kim HJ, Kim CY, Park EK et al. Volumetric analysis and indocyanine green retention rate at 15 min as predictors of post-hepatectomy liver failure.HPB (Oxford) 2015;17(2):159-67
2.	Derpapas MK, Contis J, Fragulidis GP et al. Correlation of the ICG test with risk factors and postoperative outcomes following hepatic resection.J BUON 2013;18(3):703-7
3.	de LiguoriCarino N, O'Reilly DA, Dajani K et al. Perioperative use of the LiMON method of indocyanine green elimination measurement for the prediction and early detection of post-hepatectomy liver failure.Eur J Surg Oncol2009;35(9):957-62



06 / Indocyanine green clearance rate as a predictive factor of complications following major liver resection