Partial Hepatic Vein Occlusion and Venous Congestion in Liver Exploration Using a Hyperspectral Camera: A Proposal for Monitoring Intraoperative Liver Perfusion

Simple Summary No measures of the changes occurring in the liver in the case of outflow deprivation during hepatectomies are available. This study investigated four indexes obtained using hyperspectral imaging in a pig model, measured in different liver lobes, before and after hepatic vein occlusion. The variations of StO(2)% and deoxy-Hb were considerably good markers of venous liver congestion. Introduction. The changes occurring in the liver in cases of outflow deprivation have rarely been investigated, and no measurements of this phenomenon are available. This investigation explored outflow occlusion in a pig model using a hyperspectral camera. Methods. Six pigs were enrolled. The right hepatic vein was clamped for 30 min. The oxygen saturation (StO(2)%), deoxygenated hemoglobin level (de-Hb), near-infrared perfusion (NIR), and total hemoglobin index (THI) were investigated at different time points in four perfused lobes using a hyperspectral camera measuring light absorbance between 500 nm and 995 nm. Differences among lobes at different time points were estimated by mixed-effect linear regression. Results. StO(2)% decreased over time in the right lateral lobe (RLL, totally occluded) when compared to the left lateral (LLL, outflow preserved) and the right medial (RML, partially occluded) lobes (p < 0.05). De-Hb significantly increased after clamping in RLL when compared to RML and LLL (p < 0.05). RML was further analyzed considering the right portion (totally occluded) and the left portion of the lobe (with an autonomous draining vein). StO(2)% decreased and de-Hb increased more smoothly when compared to the totally occluded RLL (p < 0.05). Conclusions. The variations of StO(2)% and deoxy-Hb could be considered good markers of venous liver congestion.

Automated summary

This study used hyperspectral imaging to investigate the changes in liver during hepatectomies. The variations in StO(2)% and deoxy-Hb were found to be good markers of venous liver congestion.