Preoperative risk assessment for post-hepatectomy liver failure (PHLF) by FLR, ICG and indocycanine green and development of a model predicting PHLF using all three modalities.

This study aims to improve how doctors predict the risk of post-hepatectomy liver failure (PHLF), a serious complication that can occur after liver surgery. While liver surgery has become much safer over the years, some patients still experience complications, including liver failure, which can be life-threatening. Currently, doctors use various methods to assess liver function before surgery, but no single approach is entirely reliable. 

This study focuses on combining three key preoperative tests—Future Liver Remnant (FLR) measurement, Fibroscan (a non-invasive liver stiffness test), and the Indocyanine Green (ICG) clearance test, ALBI (Albumin-bilirubin) score and APRI (Aspartate transaminase- Platelet Index) score —to develop a better way to predict PHLF and improve patient outcomes.

The study will involve 100 patients (50 as prospective and 50 as retrospective) undergoing liver surgery at the hospital. Before surgery, each patient will undergo FLR calculation using imaging techniques, a Fibroscan to assess liver stiffness, and an ICG test, which measures how well the liver processes a special dye and ALBI and APRI score calculation.

These results will then be analyzed and compared with actual surgical outcomes to determine how effectively these tests can predict PHLF. The goal is to see whether combining these methods provides a more accurate prediction than using just one or two, ultimately helping surgeons make better decisions before surgery. Since this is an observational study, no experimental treatments will be introduced. Patients will undergo their planned liver surgery with the usual preoperative assessments, and the study will simply analyze the data collected to improve future patient care. Researchers expect to find that using all three tests together will provide a clearer and more accurate picture of liver function, allowing doctors to identify high-risk patients more reliably.

This could lead to better decision-making, potentially reducing complications and improving survival rates. Patients participating in the study will provide informed consent, and all personal information will be kept strictly confidential. Any serious complications that arise will be reported immediately and handled according to hospital safety guidelines. The ultimate aim is to develop a reliable risk prediction model using these three preoperative tests, which could become a valuable tool for surgeons in planning safer liver surgeries and improving patient outcomes.