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Volumetric and functional recovery of the remnant liver after major liver resection with prior portal vein embolization : recovery after PVE and liver resection.

van den Esschert JW, de Graaf W, van Lienden KP, Busch OR, Heger M, van Delden OM, Gouma DJ, Bennink RJ, Laméris JS, van Gulik TM - J. Gastrointest. Surg. (2009)

Bottom Line: Groups were comparable for gender, age, and number of patients with a compromised liver.Prior to surgery, there were no significant differences in future remnant liver volume and function between the groups.Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Academic Medical Center, IWO-1, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

ABSTRACT

Introduction: Portal vein embolization is an accepted method to increase the future remnant liver preoperatively. The aim of this study was to assess the effect of preoperative portal vein embolization on liver volume and function 3 months after major liver resection.

Materials and methods: This is a retrospective case-control study. Data were collected of patients who underwent portal vein embolization prior to (extended) right hemihepatectomy and of control patients who underwent the same type of resection without prior portal vein embolization. Liver volumes were measured by computed tomography volumetry before portal vein embolization, before liver resection, and 3 months after liver resection. Liver function was assessed by hepatobiliary scintigraphy before and 3 months after liver resection.

Results: Ten patients were included in the embolization group and 13 in the control group. Groups were comparable for gender, age, and number of patients with a compromised liver. The mean future remnant liver volume was 33.0 +/- 8.0% prior to portal vein embolization in the embolization group and 45.6 +/- 9.1% in the control group (p < 0.01). Prior to surgery, there were no significant differences in future remnant liver volume and function between the groups. Three months postoperatively, the mean remnant liver volume was 81.9 +/- 8.9% of the initial total liver volume in the embolization group and 79.4 +/- 11.0% in the control group (p > 0.05). Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05).

Conclusion: Preoperative portal vein embolization does not negatively influence postoperative liver regeneration assessed 3 months after major liver resection.

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Related in: MedlinePlus

Uptake of 99mTc-mebrofenin by the total liver prior to any intervention and 3 months after partial liver resection. There were no significant differences in uptake between the PVE and the control groups at both time points. The remnant liver function reached 88.1% and 83,3%, respectively, of the original total liver function in both groups (p = 0.50).
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Fig3: Uptake of 99mTc-mebrofenin by the total liver prior to any intervention and 3 months after partial liver resection. There were no significant differences in uptake between the PVE and the control groups at both time points. The remnant liver function reached 88.1% and 83,3%, respectively, of the original total liver function in both groups (p = 0.50).

Mentions: The increase in percentage remnant liver volume from preoperatively to 3 months after major liver surgery was not different between the two groups (p = 0.81). Three months after surgery, the mean RLV in the PVE group was 81.9 ± 8.9% of the initial total liver volume compared to 79.4 ± 11.0% in the control group (p = 0.57; Table 1; Fig. 2). In addition, the postoperative increase in liver function did not differ between both groups (p = 0.471). Three months postoperatively, the RLF regained 88.1 ± 17.4% of the original total liver function in the PVE group compared to 83.3 ± 14% in the control group (p = 0.50; Fig. 3). No correlation was found between liver volume and function (r = 0.13, p = 0.59).Figure 2


Volumetric and functional recovery of the remnant liver after major liver resection with prior portal vein embolization : recovery after PVE and liver resection.

van den Esschert JW, de Graaf W, van Lienden KP, Busch OR, Heger M, van Delden OM, Gouma DJ, Bennink RJ, Laméris JS, van Gulik TM - J. Gastrointest. Surg. (2009)

Uptake of 99mTc-mebrofenin by the total liver prior to any intervention and 3 months after partial liver resection. There were no significant differences in uptake between the PVE and the control groups at both time points. The remnant liver function reached 88.1% and 83,3%, respectively, of the original total liver function in both groups (p = 0.50).
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2710489&req=5

Fig3: Uptake of 99mTc-mebrofenin by the total liver prior to any intervention and 3 months after partial liver resection. There were no significant differences in uptake between the PVE and the control groups at both time points. The remnant liver function reached 88.1% and 83,3%, respectively, of the original total liver function in both groups (p = 0.50).
Mentions: The increase in percentage remnant liver volume from preoperatively to 3 months after major liver surgery was not different between the two groups (p = 0.81). Three months after surgery, the mean RLV in the PVE group was 81.9 ± 8.9% of the initial total liver volume compared to 79.4 ± 11.0% in the control group (p = 0.57; Table 1; Fig. 2). In addition, the postoperative increase in liver function did not differ between both groups (p = 0.471). Three months postoperatively, the RLF regained 88.1 ± 17.4% of the original total liver function in the PVE group compared to 83.3 ± 14% in the control group (p = 0.50; Fig. 3). No correlation was found between liver volume and function (r = 0.13, p = 0.59).Figure 2

Bottom Line: Groups were comparable for gender, age, and number of patients with a compromised liver.Prior to surgery, there were no significant differences in future remnant liver volume and function between the groups.Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05).

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Academic Medical Center, IWO-1, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.

ABSTRACT

Introduction: Portal vein embolization is an accepted method to increase the future remnant liver preoperatively. The aim of this study was to assess the effect of preoperative portal vein embolization on liver volume and function 3 months after major liver resection.

Materials and methods: This is a retrospective case-control study. Data were collected of patients who underwent portal vein embolization prior to (extended) right hemihepatectomy and of control patients who underwent the same type of resection without prior portal vein embolization. Liver volumes were measured by computed tomography volumetry before portal vein embolization, before liver resection, and 3 months after liver resection. Liver function was assessed by hepatobiliary scintigraphy before and 3 months after liver resection.

Results: Ten patients were included in the embolization group and 13 in the control group. Groups were comparable for gender, age, and number of patients with a compromised liver. The mean future remnant liver volume was 33.0 +/- 8.0% prior to portal vein embolization in the embolization group and 45.6 +/- 9.1% in the control group (p < 0.01). Prior to surgery, there were no significant differences in future remnant liver volume and function between the groups. Three months postoperatively, the mean remnant liver volume was 81.9 +/- 8.9% of the initial total liver volume in the embolization group and 79.4 +/- 11.0% in the control group (p > 0.05). Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05).

Conclusion: Preoperative portal vein embolization does not negatively influence postoperative liver regeneration assessed 3 months after major liver resection.

Show MeSH
Related in: MedlinePlus