Liver Venous Deprivation (LVD) Versus Portal Vein Embolization (PVE) Alone Prior to Extended Hepatectomy: A Matched Pair Analysis.
Colorectal Neoplasms
/ pathology
Embolization, Therapeutic
/ methods
Hepatectomy
/ methods
Hepatic Veins
/ pathology
Humans
Hypertrophy
/ pathology
Liver
/ diagnostic imaging
Liver Neoplasms
/ diagnostic imaging
Matched-Pair Analysis
Portal Vein
/ pathology
Prospective Studies
Retrospective Studies
Treatment Outcome
Extended hepatectomy
Future liver remnant (FLR)
Liver venous deprivation (LVD)
Portal vein embolization (PVE)
Right hepatic vein embolization (rHVE)
Journal
Cardiovascular and interventional radiology
ISSN: 1432-086X
Titre abrégé: Cardiovasc Intervent Radiol
Pays: United States
ID NLM: 8003538
Informations de publication
Date de publication:
Jul 2022
Jul 2022
Historique:
received:
27
10
2021
accepted:
22
02
2022
pubmed:
23
3
2022
medline:
28
6
2022
entrez:
22
3
2022
Statut:
ppublish
Résumé
To investigate whether liver venous deprivation (LVD) as simultaneous, portal vein (PVE) and right hepatic vein embolization offers advantages in terms of hypertrophy induction before extended hepatectomy in non-cirrhotic liver. Between June 2018 and August 2019, 20 patients were recruited for a prospective, non-randomized study to investigate the efficacy of LVD. After screening of 134 patients treated using PVE alone from January 2015 to August 2019, 14 directly matched pairs regarding tumor entity (cholangiocarcinoma, CC and colorectal carcinoma, CRC) and hypertrophy time (defined as time from embolization to follow-up imaging) were identified. In both treatment groups, the same experienced reader (> 5 years experience) performed imaging-based measurement of the volumes of liver segments of the future liver remnant (FLR) prior to embolization and after the standard clinical hypertrophy interval (~ 30 days), before surgery. Percentage growth of segments was calculated and compared. After matched follow-up periods (mean of 30.5 days), there were no statistically significant differences in relative hypertrophy of FLRs. Mean ± standard deviation relative hypertrophy rates for LVD/PVE were 59 ± 29.6%/54.1 ± 27.6% (p = 0.637) for segments II + III and 48.2 ± 22.2%/44.9 ± 28.9% (p = 0.719) for segments II-IV, respectively. LVD had no significant advantages over the standard method (PVE alone) in terms of hypertrophy induction of the FLR before extended hepatectomy in this study population.
Sections du résumé
BACKGROUND
BACKGROUND
To investigate whether liver venous deprivation (LVD) as simultaneous, portal vein (PVE) and right hepatic vein embolization offers advantages in terms of hypertrophy induction before extended hepatectomy in non-cirrhotic liver.
MATERIALS AND METHODS
METHODS
Between June 2018 and August 2019, 20 patients were recruited for a prospective, non-randomized study to investigate the efficacy of LVD. After screening of 134 patients treated using PVE alone from January 2015 to August 2019, 14 directly matched pairs regarding tumor entity (cholangiocarcinoma, CC and colorectal carcinoma, CRC) and hypertrophy time (defined as time from embolization to follow-up imaging) were identified. In both treatment groups, the same experienced reader (> 5 years experience) performed imaging-based measurement of the volumes of liver segments of the future liver remnant (FLR) prior to embolization and after the standard clinical hypertrophy interval (~ 30 days), before surgery. Percentage growth of segments was calculated and compared.
RESULTS
RESULTS
After matched follow-up periods (mean of 30.5 days), there were no statistically significant differences in relative hypertrophy of FLRs. Mean ± standard deviation relative hypertrophy rates for LVD/PVE were 59 ± 29.6%/54.1 ± 27.6% (p = 0.637) for segments II + III and 48.2 ± 22.2%/44.9 ± 28.9% (p = 0.719) for segments II-IV, respectively.
CONCLUSIONS
CONCLUSIONS
LVD had no significant advantages over the standard method (PVE alone) in terms of hypertrophy induction of the FLR before extended hepatectomy in this study population.
Identifiants
pubmed: 35314879
doi: 10.1007/s00270-022-03107-0
pii: 10.1007/s00270-022-03107-0
pmc: PMC9226084
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
950-957Commentaires et corrections
Type : CommentIn
Informations de copyright
© 2022. The Author(s).
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