| Added by | mollevi |
|---|---|
| Last modified by | pmartino |
| Group name | EquipePM |
| Item Type | Journal Article |
| Title | Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function |
| Creator | Guiu et al. |
| Author | B. Guiu |
| Author | F. Quenet |
| Author | L. Escal |
| Author | F. Bibeau |
| Author | L. Piron |
| Author | P. Rouanet |
| Author | J. M. Fabre |
| Author | E. Jacquet |
| Author | A. Denys |
| Author | P. O. Kotzki |
| Author | D. Verzilli |
| Author | E. Deshayes |
| Abstract | OBJECTIVE: The aim of this study was to assess the safety and efficacy of extended liver venous deprivation (eLVD), i.e. combination of right portal vein embolisation and right (accessory right) and middle hepatic vein embolisation before major hepatectomy for future remnant liver (FRL) functional increase. METHODS: eLVD was performed in non-cirrhotic patients referred for major hepatectomy in a context of small FRL (baseline FRL <25% of the total liver volume or FRL function <2.69%/min/m2). All patients underwent 99mTc-mebrofenin hepatobiliary scintigraphy (HBS) and computed tomographic evaluations. RESULTS: Ten consecutive patients underwent eLVD before surgery for liver metastases (n = 8), Klatskin tumour (n = 1) and gallbladder carcinoma (n = 1). FRL function increased by 64.3% (range = 28.1-107.5%) at day 21. In patients with serial measurements, maximum FRL function was at day 7 (+65.7 +/- 16%). The FRL volume increased by +53.4% at 7 days (+25 +/- 8 cc/day). Thirty-one days (range = 22-45 days) after eLVD, 9/10 patients were resected. No post-hepatectomy liver failure was reported. Two grade II and one grade III complications (Dindo-Clavien classification) occurred. No patient died with-in 90 days following surgery. CONCLUSIONS: eLVD is safe and provides a marked and very rapid increase in liver function, unprecedented for an interventional radiology procedure. KEY POINTS: * eLVD is safe * eLVD provides a marked and very rapid increase in liver function * After eLVD, the FRL-F increased by 64.3% (28.1-107.5%) at day 21 * After eLVD, the maximum FRL-F was obtained at day 7 (+65.7 +/- 16%) * After eLVD, the FRL volume increased by +53.4% at 7 days (+25 +/- 8 cc/day). |
| Publication | Eur Radiol |
| Date | Jan 18 2017 |
| Journal Abbr | European radiology |
| DOI | 10.1007/s00330-017-4744-9 |
| ISSN | 1432-1084 (Electronic) 0938-7994 (Linking) |
| Call Number | IMPACT: 4.027 |
| Extra | IMPACT: 4.027 |
| Tags | Aged, Bile Duct Neoplasms, clinic, Embolization, Therapeutic, Female, Gallbladder Neoplasms, Hepatectomy, Hepatic vein, Hepatic Veins, Humans, Imino Acids, Klatskin Tumor, Liver, Liver Failure, Liver Function Tests, Liver Neoplasms, Male, Middle Aged, Organotechnetium Compounds, original, Portal Vein, Portal vein embolisation, Preoperative Care, Radiopharmaceuticals, Retrospective Studies, Scintigraphy, Single Photon Emission Computed Tomography Computed Tomography, Surgery, Tomography, X-Ray Computed |
| Date Added | 2018/07/20 - 09:15:34 |
| Date Modified | 2021/03/05 - 10:45:05 |
| Notes and Attachments | (Note) (Note) (Note) (Note) 28101681 (Attachment) |
Institut de Recherche en Cancérologie de
