Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma
Preoperative portal vein embolization (PVE) is increasingly used to optimize the volume and function of the future liver remnant (FLR) and to reduce the risk for complications of major hepatectomy for hepatocellular carcinoma (HCC) or hilar cholangiocarcinoma (CCA). In patients with HCC who are cand...
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2008
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| Online Access: | http://hdl.handle.net/10725/2583 http://dx.doi.org/10.1055/s-2008-1076684 https://www.thieme-connect.com/products/ejournals/html/10.1055/s-2008-1076684 |
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| _version_ | 1864513458661228544 |
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| author | Anaya, Daniel |
| author2 | Blazer, Dan Abdalla, Eddie |
| author2_role | author author |
| author_facet | Anaya, Daniel Blazer, Dan Abdalla, Eddie |
| author_role | author |
| dc.creator.none.fl_str_mv | Anaya, Daniel Blazer, Dan Abdalla, Eddie |
| dc.date.none.fl_str_mv | 2008 2015-11-16T12:34:03Z 2015-11-16T12:34:03Z 2015-11-16 |
| dc.identifier.none.fl_str_mv | 0739-9529 http://hdl.handle.net/10725/2583 http://dx.doi.org/10.1055/s-2008-1076684 Anaya, D. A., Blazer III, D. G., & Abdalla, E. K. (2008, June). Strategies for resection using portal vein embolization: hepatocellular carcinoma and hilar cholangiocarcinoma. In Seminars in interventional radiology (Vol. 25, No. 2, p. 110). Thieme Medical Publishers. https://www.thieme-connect.com/products/ejournals/html/10.1055/s-2008-1076684 |
| dc.language.none.fl_str_mv | en |
| dc.relation.none.fl_str_mv | Seminars interventional in radiology |
| dc.rights.*.fl_str_mv | info:eu-repo/semantics/openAccess |
| dc.title.none.fl_str_mv | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| dc.type.none.fl_str_mv | Article info:eu-repo/semantics/publishedVersion info:eu-repo/semantics/article |
| description | Preoperative portal vein embolization (PVE) is increasingly used to optimize the volume and function of the future liver remnant (FLR) and to reduce the risk for complications of major hepatectomy for hepatocellular carcinoma (HCC) or hilar cholangiocarcinoma (CCA). In patients with HCC who are candidates for extended hepatectomy and in patients with HCC and well-compensated cirrhosis who are being considered for major hepatectomy, FLR volumetry is routinely performed, and PVE is employed in selected cases to optimize the volume and function of the FLR prior to surgery. Similarly, in patients with hilar CCA who are candidates for extended hepatectomy, careful preoperative preparation using biliary drainage, FLR volumetry, and PVE optimizes the volume and function of the FLR prior to surgery. Appropriate use of PVE has led to improved postoperative outcomes after major hepatectomy for these diseases and oncological outcomes similar to those in patients who undergo resection without PVE. Specific indications for PVE are being clarified. FLR volumetry is necessary for proper selection of patients for PVE. Analysis of the degree of hypertrophy of the FLR after PVE (a dynamic test of liver regeneration) complements analysis of the pre-PVE FLR volume (a static test). Together, FLR degree of hypertrophy and FLR volume are the best predictors of outcome after major hepatectomy in an individual patient, regardless of the degree of underlying liver disease. This article synthesizes the literature on the approach to patients with HCC and CCA who are candidates for major hepatectomy. The rationale and indications for FLR volumetry and PVE and outcomes following PVE and major hepatectomy for HCC and CCA are discussed. |
| eu_rights_str_mv | openAccess |
| format | article |
| id | LAURepo_814dfc4b289564dbabf4ffcb94f99a30 |
| identifier_str_mv | 0739-9529 Anaya, D. A., Blazer III, D. G., & Abdalla, E. K. (2008, June). Strategies for resection using portal vein embolization: hepatocellular carcinoma and hilar cholangiocarcinoma. In Seminars in interventional radiology (Vol. 25, No. 2, p. 110). Thieme Medical Publishers. |
| language_invalid_str_mv | en |
| network_acronym_str | LAURepo |
| network_name_str | Lebanese American University repository |
| oai_identifier_str | oai:laur.lau.edu.lb:10725/2583 |
| publishDate | 2008 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| spelling | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar CholangiocarcinomaAnaya, DanielBlazer, DanAbdalla, EddiePreoperative portal vein embolization (PVE) is increasingly used to optimize the volume and function of the future liver remnant (FLR) and to reduce the risk for complications of major hepatectomy for hepatocellular carcinoma (HCC) or hilar cholangiocarcinoma (CCA). In patients with HCC who are candidates for extended hepatectomy and in patients with HCC and well-compensated cirrhosis who are being considered for major hepatectomy, FLR volumetry is routinely performed, and PVE is employed in selected cases to optimize the volume and function of the FLR prior to surgery. Similarly, in patients with hilar CCA who are candidates for extended hepatectomy, careful preoperative preparation using biliary drainage, FLR volumetry, and PVE optimizes the volume and function of the FLR prior to surgery. Appropriate use of PVE has led to improved postoperative outcomes after major hepatectomy for these diseases and oncological outcomes similar to those in patients who undergo resection without PVE. Specific indications for PVE are being clarified. FLR volumetry is necessary for proper selection of patients for PVE. Analysis of the degree of hypertrophy of the FLR after PVE (a dynamic test of liver regeneration) complements analysis of the pre-PVE FLR volume (a static test). Together, FLR degree of hypertrophy and FLR volume are the best predictors of outcome after major hepatectomy in an individual patient, regardless of the degree of underlying liver disease. This article synthesizes the literature on the approach to patients with HCC and CCA who are candidates for major hepatectomy. The rationale and indications for FLR volumetry and PVE and outcomes following PVE and major hepatectomy for HCC and CCA are discussed.PublishedN/A2015-11-16T12:34:03Z2015-11-16T12:34:03Z20082015-11-16Articleinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article0739-9529http://hdl.handle.net/10725/2583http://dx.doi.org/10.1055/s-2008-1076684Anaya, D. A., Blazer III, D. G., & Abdalla, E. K. (2008, June). Strategies for resection using portal vein embolization: hepatocellular carcinoma and hilar cholangiocarcinoma. In Seminars in interventional radiology (Vol. 25, No. 2, p. 110). Thieme Medical Publishers.https://www.thieme-connect.com/products/ejournals/html/10.1055/s-2008-1076684enSeminars interventional in radiologyinfo:eu-repo/semantics/openAccessoai:laur.lau.edu.lb:10725/25832016-08-11T07:12:16Z |
| spellingShingle | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma Anaya, Daniel |
| status_str | publishedVersion |
| title | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| title_full | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| title_fullStr | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| title_full_unstemmed | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| title_short | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| title_sort | Strategies for Resection Using Portal Vein Embolization: Hepatocellular Carcinoma and Hilar Cholangiocarcinoma |
| url | http://hdl.handle.net/10725/2583 http://dx.doi.org/10.1055/s-2008-1076684 https://www.thieme-connect.com/products/ejournals/html/10.1055/s-2008-1076684 |