Parenchymal-sparing hepatectomy with hepatic vein resection and reconstruction.
Future liver remnant
hepatic vein reconstruction
hepatobiliary scintigraphy
major hepatectomy
parenchymal saving liver surgery
Journal
Acta chirurgica Belgica
ISSN: 0001-5458
Titre abrégé: Acta Chir Belg
Pays: England
ID NLM: 0370571
Informations de publication
Date de publication:
Oct 2022
Oct 2022
Historique:
pubmed:
17
4
2021
medline:
28
9
2022
entrez:
16
4
2021
Statut:
ppublish
Résumé
Hepatectomy remains the most important treatment modality for most malignant liver tumors. Vascular involvement stays a reason for unresectability or major parenchymal resection. A possible way to avoid this is parenchymal-sparing hepatectomy (PSHX) with vascular resection and reconstruction (HVRR). In this article, we aim to demonstrate the specific role of this technique in avoiding post-hepatectomy liver failure (PHLF). A retrospective analysis of 10 patients who underwent HVRR was conducted. In our cohort, there was no perioperative mortality. Two patients suffered a Clavien-Dindo grade 3a complication and none had clinically significant PHLF. Estimated FLRF was significantly higher in HVRR compared to major hepatectomy after portal vein embolization ( Instead of focusing on inducing liver remnant hypertrophy, preserving parenchyma through HVRR can be an interesting treatment strategy. It can be performed with an acceptable operative risk. Calculations of FLRF (using HBS) suggest that this approach is able to reduce the risk for PHLF and related morbidity or mortality.
Sections du résumé
BACKGROUND
UNASSIGNED
Hepatectomy remains the most important treatment modality for most malignant liver tumors. Vascular involvement stays a reason for unresectability or major parenchymal resection. A possible way to avoid this is parenchymal-sparing hepatectomy (PSHX) with vascular resection and reconstruction (HVRR). In this article, we aim to demonstrate the specific role of this technique in avoiding post-hepatectomy liver failure (PHLF).
METHODS
UNASSIGNED
A retrospective analysis of 10 patients who underwent HVRR was conducted.
RESULTS
UNASSIGNED
In our cohort, there was no perioperative mortality. Two patients suffered a Clavien-Dindo grade 3a complication and none had clinically significant PHLF. Estimated FLRF was significantly higher in HVRR compared to major hepatectomy after portal vein embolization (
CONCLUSIONS
UNASSIGNED
Instead of focusing on inducing liver remnant hypertrophy, preserving parenchyma through HVRR can be an interesting treatment strategy. It can be performed with an acceptable operative risk. Calculations of FLRF (using HBS) suggest that this approach is able to reduce the risk for PHLF and related morbidity or mortality.
Identifiants
pubmed: 33860723
doi: 10.1080/00015458.2021.1915021
pii: 10.1080/00015458.2021.1915021
doi:
Substances chimiques
Aniline Compounds
0
Technetium
7440-26-8
mebrofenin
7PV0B6ED98
Glycine
TE7660XO1C
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM