关键词: 标准化剩余肝体积, 肝硬度值, 肝脏切除术, 肝功能不全

Abstract: Objective To explore the clinical value of the ratio of standardized residual liver volume to liver hardness in predicting liver dysfunction after hepatectomy. Methods The clinical data of 61 patients who underwent hepatectomy in our hospital from January 2015 to June 2021 were analyzed retrospectively. Before operation, CT or MR were used for liver enhancement scanning, and the images were examined for three-dimensional reconstruction. Anatomical left or right hepatectomy is planned according to the location of liver tumor. The whole liver volume and the remaining liver volume were calculated according to the proposed surgical scheme. At the same time, 61 patients were examined by liver ultrasound and transient elastic imaging to detect the liver hardness value （KPA） of each patient, calculate the ratio of standardized remaining liver volume to liver hardness value （SFLV/KPA）, and observe whether 61 patients had postoperative liver insufficiency. The possible related factors causing postoperative liver insufficiency were analyzed by univariate analysis, and the factors related to postoperative liver insufficiency were obtained. Then the correlation between these factors and postoperative liver insufficiency was analyzed by binary logistic regression analysis, and the role of standardized ratio of residual liver volume to liver stiffness value （SFLV/KPA） in predicting liver insufficiency after hepatectomy was discussed. The relationship between SFLV/KPA and postoperative liver dysfunction was determined by receiver operating characteristic curve and ROC curve. Results All 61 patients were operated successfully. Seven patients had liver dysfunction, no patient had liver failure and no patient died after operation. The results of logistic regression analysis showed that intraoperative bleeding, hilar blocking time, SFLV/KPA and operation method were the influencing factors of postoperative liver dysfunction. Conclusion According to the receiver operating characteristic curve ROC curve, when the ratio of SFLV/KPA （standardized residual liver volume/liver hardness） is greater than 30.6, patients generally do not have liver dysfunction after operation, and the operation safety is higher.

Key words: standardized residual liver volume, liver hardness value, hepatectomy, liver dysfunction