Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma.
Details
Serval ID
serval:BIB_38452DFE18C9
Type
Article: article from journal or magazin.
Collection
Publications
Institution
Title
Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma.
Journal
HPB
Working group(s)
EuroLVD and DRAGON Trials Collaborative
Contributor(s)
Chevallier P., Wigmore S., Newhook T., Vauthey J.N., Memeo R., Dasari B.V., Braunwarth E., Aldrighetti L., Andorrà E.C., Arntz P., Arslan B., van Baardewijk L., Baclija I., Ball C., Barbier L., Bednarsch J., Bemelmans M., Bent C., van den Bergh F., Billingsley K., Binkert C., Björnsson B., de Boer M.T., Bokkers RPH, de Boo D., Garcia Borobia F.J., Braat D., Breen D., Breitenstein S., Brousseau K., Bruijnen R., Bruners P., Bruns C., Bunck A., Burgmans M., Cappelli A., Carling U., de Carvalho L.A., Cha C., Chan B., Chand B., Chapelle T., De Cobelli F., Coubeau L., Criado E., Croagh D., D'Hondt M., van Dam R., Damink S.O., Davis R., Delle M., Denys A., Deprez F., Detry O., Dewulf M., Dili A., Dixon M., Díaz-Nieto R., Erdmann J.I., Fernando R., Font J.C., Fouraschen S., François O., Fretland Å.A., Fundora Y., Gadani S., Gallinger S., Geleabert A., Gerard L., Giménez J.G., Gobardhan P., Goffette P., Grochola L.F., Gruenberger T., Grünhagen D., Guiliante F., Gómez F., Hagendoorn J., Hammond J., Heijmans M., Heil J., Heise D., Hermie L., Herrero E., Hess G., Heye S., Hoffmann M., Iezzi R., Imani F., James S., Jardinet T., Joshi K., Jovine E., Kalil J., Karanicolas P., Kazemier G., Kern L., Kingham P., Klass D., Koerkamp B.G., Kollmar O., Korenblik R., Kwon C., Lambrecht C., Lang S., X. LA, Leclercq W., van der Leij C., Lindsay R., Lopez-Ben S., Lucidi V., López J.N., Macdonald A., Madoff D.C., Markose G., Maroune G., Martel G., Martin E.S., Mehrzad H., Meijerink M., Melloul E., Messaoudi N., Metrakos P., Modi S., Montanari N., Moragues J.S., Mujoomdar A., Neumann U., Oor J., Pappas P., Pieterman K., Primrose J., Qu X., Ratti F., Ridouani F., Borel Rinkes IHM, Casellas I Robert M., Ross S., Ruo L., Ryan S., Salik A., Sandström P., Santol J., Sarría L., Schaarschmidt B., Schadde E., Schiesser M., Schmelzle M., Seeger N., Segedi M., Serenari M., Sergeant G., Serrablo A., Simon S., Skaro A., Smits M., Smits J., Snitzbauer A., Soonawalla Z., Sparrelid E., Spuentrup E., Stavrou G., Sutcliffe R., Swijnenburg R.J., Tancredi I., Tasse J.C., Tschögl M., Udupa V., Valenti D.A., Vass D., van der Velden A.L., Vogl T., Wacker F., Wang X., Weitz J., White S., Widyaningsih R., De Wispelaere J.F., Zijlstra I.
ISSN
1477-2574 (Electronic)
ISSN-L
1365-182X
Publication state
Published
Issued date
12/2024
Peer-reviewed
Oui
Volume
26
Number
12
Pages
1458-1466
Language
english
Notes
Publication types: Journal Article ; Multicenter Study ; Observational Study
Publication Status: ppublish
Publication Status: ppublish
Abstract
Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates.
In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023.
Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%.
PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection.
In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023.
Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%.
PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection.
Keywords
Humans, Male, Retrospective Studies, Bile Duct Neoplasms/surgery, Bile Duct Neoplasms/mortality, Bile Duct Neoplasms/therapy, Bile Duct Neoplasms/pathology, Female, Klatskin Tumor/surgery, Klatskin Tumor/therapy, Klatskin Tumor/mortality, Embolization, Therapeutic/adverse effects, Hepatectomy, Aged, Middle Aged, Portal Vein/surgery, Hepatic Veins, Treatment Outcome, Postoperative Complications/etiology, Time Factors, Liver Failure/etiology
Pubmed
Create date
20/09/2024 13:51
Last modification date
14/12/2024 7:25
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