| Added by | pmartino |
|---|---|
| Group name | EquipePM |
| Item Type | Journal Article |
| Title | Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes |
| Creator | Guiu et al. |
| Author | Boris Guiu |
| Author | Fabrizio Panaro |
| Author | Lauranne Piron |
| Author | Christophe Cassinotto |
| Author | Astrid Herrerro |
| Author | François-Régis Souche |
| Author | Margaux Hermida |
| Author | Marie-Ange Pierredon-Foulongne |
| Author | Ali Belgour |
| Author | Serge Aho-Glele |
| Author | Emmanuel Deshayes |
| Abstract | Background: We previously showed that embolization of portal inflow and hepatic vein (HV) outflow (liver venous deprivation, LVD) promotes future liver remnant (FLR) volume (FLR-V) and function (FLR-F) gain. Here, we compared FLR-V and FLR-F changes after portal vein embolization (PVE) and LVD. Methods: This study included all patients referred for liver preparation before major hepatectomy over 26 months. Exclusion criteria were: unavailable baseline/follow-up imaging, cirrhosis, Klatskin tumor, two-stage hepatectomy. 99mTc-mebrofenin SPECT-CT was performed at baseline and at day 7, 14 and 21 after PVE or LVD. FLR-V and FLR-F variations were compared using multivariate generalized linear mixed models (joint modelling) with/without missing data imputation. Results: Baseline FLR-F was lower in the LVD (n=29) than PVE group (n=22) (P<0.001). Technical success was 100% in both groups without any major complication. Changes in FLR-V at day 14 and 21 (+14.2% vs. +50%, P=0.002; and +18.6% vs. +52.6%, P=0.001), and in FLR-F at day 7, 14 and 21 (+23.1% vs. +54.3%, P=0.02; +17.6% vs. +56.1%, P=0.006; and +29.8% vs. +63.9%, P<0.001) differed between PVE and LVD group. LVD (P=0.009), age (P=0.027) and baseline FLR-V (P=0.001) independently predicted FLR-V variations, whereas only LVD (P=0.01) predicted FLR-F changes. After missing data handling, LVD remained an independent predictor of FLR-V and FLR-F variations. Conclusions: LVD is safe and provides greater FLR-V and FLR-F increase than PVE. These results are now evaluated in the HYPERLIV-01 multicenter randomized trial. |
| Publication | Hepatobiliary Surgery and Nutrition |
| Volume | 9 |
| Issue | 5 |
| Pages | 564-576 |
| Date | 2020-10 |
| Journal Abbr | Hepatobiliary Surg Nutr |
| Language | eng |
| DOI | 10.21037/hbsn.2020.02.06 |
| ISSN | 2304-3881 |
| Short Title | Liver venous deprivation versus portal vein embolization before major hepatectomy |
| Library Catalog | PubMed |
| Extra | 00000 PMID: 33163507 PMCID: PMC7603937 |
| Tags | clinic, mebrofenin, Portal vein embolization (PVE), resection |
| Date Added | 2021/03/05 - 09:48:13 |
| Date Modified | 2021/05/07 - 14:11:46 |
| Notes and Attachments | Full Text (Attachment) Full Text (Attachment) Full Text (Attachment) PubMed entry (Attachment) PubMed entry (Attachment) PubMed entry (Attachment) |
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