Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome
Background: This study evaluated the safety of portal vein embolization (PVE), its impact on future liver remnant (FLR) volume and regeneration, and subsequent effects on outcome after liver resection. Methods: Records of 112 patients were reviewed. Standardized FLR (sFLR) and degree of hypertrophy...
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| Format: | article |
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2007
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| Online Access: | http://hdl.handle.net/10725/2577 http://dx.doi.org/10.1002/bjs.5836 http://onlinelibrary.wiley.com/doi/10.1002/bjs.5836/full |
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| Summary: | Background: This study evaluated the safety of portal vein embolization (PVE), its impact on future liver remnant (FLR) volume and regeneration, and subsequent effects on outcome after liver resection. Methods: Records of 112 patients were reviewed. Standardized FLR (sFLR) and degree of hypertrophy (DH; difference between the sFLR before and after PVE), complications and outcomes were analysed to determine cut-offs that predict postoperative hepatic dysfunction. Results: Ten (8·9 per cent) of 112 patients had PVE-related complications. Postoperative complications occurred in 34 (44 per cent) of 78 patients who underwent hepatic resection and the 90-day mortality rate was 3 per cent. A sFLR of 20 per cent or less after PVE or DH of not more than 5 per cent (versus sFLR greater than 20 per cent and DH above 5 per cent) had a sensitivity of 80 per cent and a specificity of 94 per cent in predicting hepatic dysfunction. Overall, major and liver-related complications, hepatic dysfunction or insufficiency, hospital stay and 90-day mortality rate were significantly greater in patients with a sFLR of 20 per cent or less or DH of not more than 5 per cent compared with patients with higher values. Conclusion: DH contributes prognostic information additional to that gained by volumetric evaluation in patients undergoing PVE. Copyright © 2007 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. |
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