Hepatic resection volume in hepatocellular carcinoma by oral glucose tolerance test and it's relationship with postoperative liver failure / 国际外科学杂志

ABSTRACT

Objective This prospective study was performed to evaluate the role of oral glucose toler-ance test(OGTF) in evaluating the preoperative status and postoperative complications of patients with hepa-tocellular carcinoma. Methods One hundred and twenty-eight patients with primary hepatic carcinoma (PHC) were divided into 3 groups according to the resection, in which the resection of no more than 1 seg-ment called group A, the resection of 1-2 segments called group B, the resection of more than 2 segments called group C. OGTT, routine liver function tests and Child-Pugh classification were performed in these pa-tients preoperatively. The postoperative complications were also recorded. Results Blood glucose lever of 60 min and 120 min after glucose loading test in Child B (11.23 mmol/L ± 2. 78 mmol/L, 11.79 mmol/L± 3.48 mmol/L) were significantly higher than that in Child A (8.56 mmol/L±2. 36 mmol/L, 6. 78 mmol/L ±1.60 mmol/L,P <0.01) ,but the blood glucose lever of 0 min and 30 min showed no difference. The rate of diagonis of DM in Child B was 28. 30% ,which was higher than Child A(13.33% ,P =0. 035). The OG-TT results for the L-shaped curve showed that postoperative complications were significantly higher than that of type I and P in group A and B. I-shaped and L-shaped were found ascites in group C. The cases with jaun-dice all showed L-shaped curve. When the patients' OGTT curve was P -shaped, the ascites production rate was no significantly different in these three groups. With the increase of the removal in liver, ascites produc-tion rate increased evidently in I-type and L-type(P < 0. 05). Conclusions OGTT is worthwhile to assess hepatic function reserve and postoperative complications for patients with PHC. Combination of OGTT and Child-Pugh classification has higher predictive value on hepatic function reserve.