Liver Venous Deprivation (LVD) Versus Portal Vein Embolization (PVE) Alone Prior to Extended Hepatectomy: A Matched Pair Analysis

被引:16
|
作者
Boening, Georg [1 ,2 ,3 ,4 ]
Fehrenbach, Uli [1 ,2 ,3 ,4 ]
Auer, Timo Alexander [1 ,2 ,3 ,4 ,10 ]
Neumann, Konrad [5 ,6 ,7 ,8 ]
Jonczyk, Martin [1 ,2 ,3 ,4 ,10 ]
Pratschke, Johann [2 ,3 ,4 ,9 ]
Schoening, Wenzel [2 ,3 ,4 ,9 ]
Schmelzle, Moritz [2 ,3 ,4 ,9 ]
Gebauer, Bernhard [1 ,2 ,3 ,4 ]
机构
[1] Charite Univ Med Berlin, Dept Radiol, Augustenburger Pl 1, D-13353 Berlin, Germany
[2] Free Univ Berlin, Augustenburger Pl 1, D-13353 Berlin, Germany
[3] Humboldt Univ, Augustenburger Pl 1, D-13353 Berlin, Germany
[4] Berlin Inst Hlth, Augustenburger Pl 1, D-13353 Berlin, Germany
[5] Charite Univ Med Berlin, Inst Biometry & Clin Epidemiol, Charitepl 1, D-10117 Berlin, Germany
[6] Free Univ Berlin, Charitepl 1, D-10117 Berlin, Germany
[7] Humboldt Univ, Charitepl 1, D-10117 Berlin, Germany
[8] Berlin Inst Hlth, Charitepl 1, D-10117 Berlin, Germany
[9] Charite Univ Med Berlin, Dept Surg, Augustenburger Pl 1, D-13353 Berlin, Germany
[10] Berlin Inst Hlth BIH, Anna Louisa Karsch Str 2, D-10178 Berlin, Germany
关键词
Liver venous deprivation (LVD); Portal vein embolization (PVE); Right hepatic vein embolization (rHVE); Future liver remnant (FLR); Extended hepatectomy; MAJOR HEPATECTOMY; REMNANT; REGENERATION; HYPERTROPHY; RESECTION; INDUCE;
D O I
10.1007/s00270-022-03107-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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 Between June 2018 and August 2019, 20 patients were recruited for a prospective, nonrandomized 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 ( similar to 30 days), before surgery. Percentage growth of segments was calculated and compared. 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 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.
引用
收藏
页码:950 / 957
页数:8
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