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Br J Surg. 2007 Nov;94(11):1386-94.

Portal vein embolization before major hepatectomy and its effects on regeneration, resectability and outcome.

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  • 1Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA.

Abstract

BACKGROUND:

This study evaluated the safety of portal vein embolization (PVE), its impact on future liver remnant (FLR) volume and regeneration, and subsequent effects on outcome after liver resection.

METHODS:

Records of 112 patients were reviewed. Standardized FLR (sFLR) and degree of hypertrophy (DH; difference between the sFLR before and after PVE), complications and outcomes were analysed to determine cut-offs that predict postoperative hepatic dysfunction.

RESULTS:

Ten (8.9 per cent) of 112 patients had PVE-related complications. Postoperative complications occurred in 34 (44 per cent) of 78 patients who underwent hepatic resection and the 90-day mortality rate was 3 per cent. A sFLR of 20 per cent or less after PVE or DH of not more than 5 per cent (versus sFLR greater than 20 per cent and DH above 5 per cent) had a sensitivity of 80 per cent and a specificity of 94 per cent in predicting hepatic dysfunction. Overall, major and liver-related complications, hepatic dysfunction or insufficiency, hospital stay and 90-day mortality rate were significantly greater in patients with a sFLR of 20 per cent or less or DH of not more than 5 per cent compared with patients with higher values.

CONCLUSION:

DH contributes prognostic information additional to that gained by volumetric evaluation in patients undergoing PVE.

Copyright (c) 2007 British Journal of Surgery Society Ltd.

Comment in

PMID:
17583900
[PubMed - indexed for MEDLINE]
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