Liver function stress test - Chocolate stress test

Surgical resection remains the only curative treatment for primary or secondary liver tumors. Preoperative evaluation of the future remnant liver (FRL) is important in the assessment of patients undergoing major liver resection. Liver resection performed in absence of a sufficient FRL can lead to post-hepatectomy liver failure, a severe life-threatening complication.



99mTc-mebrofenin hepatobiliary scintigraphy (HBS) is a quantitative liver function test and is used to assess total liver function (TLF) in patients scheduled for major liver resection



Normally, HBS is performed after a 4 hours fast. The hepatocytes are presumably in a resting state which might reflect the resting liver function. It is presumable that the liver has a reserve capacity during stimulation. Knowledge of the stimulated liver function could be of interest for optimal patient selection, especially patients with borderline FRL function, since TLF might be underestimated in fasting patients.



We aim to explore changes in the TLF, expressed in mebrofenin uptake rate (%/min/m2) after stimulation with a fatty food challenge prior to HBS.

We expect to demonstrate an increase in total liver function after stimulation with a fatty food challenge in comparison with fasting state; liver functional reserve capacity.

We expect younger individuals to differ in total liver function and functional reserve capacity compared to the elderly (≥75 years)

12 patients between 50-60 years old

12 patients ≥75 years old

We hope to have included all 24 patients before the end of 2017

Subjects will undergo HBS twice during 2 visits. For the second HBS-scan, 250 mL full fat chocolate milk will be administered to the participating subjects 30 minutes prior to the scan.