Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant |
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Authors: | Dieter C Broering MD Christian Hillert MD Gerrit Krupski MD Lutz Fischer MD Lars Mueller MD Eike G Achilles MD Jan Schulte am Esch MD Xavier Rogiers MD |
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Institution: | 1. Departments of Hepatobiliary Surgery, University Hospital, Hamburg, Germany 3. Department of Radiology, UniversityHospital, Hamburg, Germany
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Abstract: | The objective of this study was to assess the efficacy of right portal vein embolization (PVE) vs. right portal vein ligation
(PVL) for induction of hypertrophy of the left lateral liver lobe before extended right hepatectomy. Thirty-four patients
with primary or secondary liver tumors and estimated remnant functional liver parenchyma of less than 0.5% of body weight
underwent either right PVE (transcutaneous, n= 10; transileocolic, n =7) or right PVL (n=17). Liver volume was assessed by
CT scan before occlusion of the right portal vein and prior to resection. There were no deaths. The morbidity rate in each
group was 5.8% (PVE, 1 abscess; PVL, 1 bile leak). The increase in liver volume was significantly higher after PVE compared
with PVL (188±81 ml vs. 123±58 ml) (P= 0.012). Postoperative hospital stay was significantly shorter after PVE in comparison
to PVL (4±2.9 days vs. 8.1±5.1 days;P<0.01). Curative liver resection was performed in 10 of 17 patients after PVE and 11
of 17 patients after PVL. PVE and PVL were found to be feasible and safe methods of increasing the remnant functional liver
volume and achieving resectability for extended liver tumors. PVE results in a significantly more efficient increase in liver
volume and a shorter hospital stay.
Presented at the Forty-Third Annual Meeting of The Society for Surgery of the Alimentary Tract, San Francisco, California,
May 19–22, 2002 (oral presentation). |
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Keywords: | Portal vein embolization portal vein ligation extended liver resection remnant liver volume |
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