Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function.
Details
Serval ID
serval:BIB_D2A0CA6DBC1C
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function.
Journal
European radiology
ISSN
1432-1084 (Electronic)
ISSN-L
0938-7994
Publication state
Published
Issued date
08/2017
Peer-reviewed
Oui
Volume
27
Number
8
Pages
3343-3352
Language
english
Notes
Publication types: Evaluation Studies ; Journal Article
Publication Status: ppublish
Publication Status: ppublish
Abstract
The aim of this study was to assess the safety and efficacy of extended liver venous deprivation (eLVD), i.e. combination of right portal vein embolisation and right (accessory right) and middle hepatic vein embolisation before major hepatectomy for future remnant liver (FRL) functional increase.
eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2.69%/min/m javax.xml.bind.JAXBElement@3c7ada5a ). All patients underwent javax.xml.bind.JAXBElement@33a16b03 Tc-mebrofenin hepatobiliary scintigraphy (HBS) and computed tomographic evaluations.
Ten consecutive patients underwent eLVD before surgery for liver metastases (n = 8), Klatskin tumour (n = 1) and gallbladder carcinoma (n = 1). FRL function increased by 64.3% (range = 28.1-107.5%) at day 21. In patients with serial measurements, maximum FRL function was at day 7 (+65.7 ± 16%). The FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day). Thirty-one days (range = 22-45 days) after eLVD, 9/10 patients were resected. No post-hepatectomy liver failure was reported. Two grade II and one grade III complications (Dindo-Clavien classification) occurred. No patient died with-in 90 days following surgery.
eLVD is safe and provides a marked and very rapid increase in liver function, unprecedented for an interventional radiology procedure.
• eLVD is safe • eLVD provides a marked and very rapid increase in liver function • After eLVD, the FRL-F increased by 64.3% (28.1-107.5%) at day 21 • After eLVD, the maximum FRL-F was obtained at day 7 (+65.7 ± 16%) • After eLVD, the FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day).
eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2.69%/min/m javax.xml.bind.JAXBElement@3c7ada5a ). All patients underwent javax.xml.bind.JAXBElement@33a16b03 Tc-mebrofenin hepatobiliary scintigraphy (HBS) and computed tomographic evaluations.
Ten consecutive patients underwent eLVD before surgery for liver metastases (n = 8), Klatskin tumour (n = 1) and gallbladder carcinoma (n = 1). FRL function increased by 64.3% (range = 28.1-107.5%) at day 21. In patients with serial measurements, maximum FRL function was at day 7 (+65.7 ± 16%). The FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day). Thirty-one days (range = 22-45 days) after eLVD, 9/10 patients were resected. No post-hepatectomy liver failure was reported. Two grade II and one grade III complications (Dindo-Clavien classification) occurred. No patient died with-in 90 days following surgery.
eLVD is safe and provides a marked and very rapid increase in liver function, unprecedented for an interventional radiology procedure.
• eLVD is safe • eLVD provides a marked and very rapid increase in liver function • After eLVD, the FRL-F increased by 64.3% (28.1-107.5%) at day 21 • After eLVD, the maximum FRL-F was obtained at day 7 (+65.7 ± 16%) • After eLVD, the FRL volume increased by +53.4% at 7 days (+25 ± 8 cc/day).
Keywords
Aged, Bile Duct Neoplasms/surgery, Embolization, Therapeutic/adverse effects, Embolization, Therapeutic/methods, Female, Gallbladder Neoplasms/surgery, Hepatectomy/adverse effects, Hepatectomy/methods, Hepatic Veins, Humans, Imino Acids, Klatskin Tumor/surgery, Liver/blood supply, Liver/diagnostic imaging, Liver/physiopathology, Liver Failure/etiology, Liver Failure/prevention & control, Liver Function Tests, Liver Neoplasms/secondary, Liver Neoplasms/surgery, Male, Middle Aged, Organotechnetium Compounds, Portal Vein, Preoperative Care/methods, Radiopharmaceuticals, Retrospective Studies, Single Photon Emission Computed Tomography Computed Tomography/methods, Tomography, X-Ray Computed, Hepatic vein, Liver, Portal vein embolisation, Scintigraphy, Surgery
Pubmed
Web of science
Create date
20/01/2017 17:15
Last modification date
20/08/2019 16:52