Safety and efficacy of right portal vein embolization in patients with prior leftâ¯lateral liver resection.
Acta Radiol
; 63(6): 727-733, 2022 Jun.
Article
em En
| MEDLINE
| ID: mdl-33951926
ABSTRACT
BACKGROUND:
In patients with bilobar metastatic liver disease, surgical clearance of both liver lobes may be achieved through multiple-stage liver resections. For patients with extensive disease, a major two-staged hepatectomy consisting of resection of liver segmentsâ¯IIâ¯and III before right-sided portal vein embolization (PVE) and resection of segments V-VIII may be performed, leaving only segments IV ± I as the liver remnant.PURPOSE:
To describe the outcome following right-sided PVE after prior complete resection of liver segments II and III. MATERIAL ANDMETHODS:
In this retrospective study, 15 patients (mean age = 60.4 ± 9.3 years) with liver metastases from colorectal cancer (n = 14) and uveal melanoma (n = 1) who were scheduled to undergo a major two-stage hepatectomy, were included. Total liver volume (TLV)â¯and volume of the future liver remnant (FLR) were measured on pre- and postinterventional computed tomography (CT) scans, and standardized FLR volumes (ratio FLR/TLV) were calculated.â¯Patient data were retrospectively analyzed regarding peri- and postinterventional complications, with special emphasis on liver function tests.RESULTS:
Theâ¯meanâ¯standardized post-PVE FLR volume wasâ¯26.9% ± 6.4% and no patient developed hepatic insufficiency after the PVE.â¯Based on FLR hypertrophy and liver function tests, all but one patient were considered eligible for the subsequent right-sided hepatectomy. However, due to local tumor progression, only 9/15 patients eventually proceeded to the second stage of surgery. â¯.CONCLUSION:
Right-sided PVE was safe and efficacious in this cohort of patients who had previously undergone a complete resection of liver segments II and III as part of a major staged hepatectomy pathway leaving only segments IV(±I) as the FLR.â¯.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Embolização Terapêutica
/
Neoplasias Hepáticas
Tipo de estudo:
Observational_studies
Limite:
Aged
/
Humans
/
Middle aged
Idioma:
En
Revista:
Acta Radiol
Ano de publicação:
2022
Tipo de documento:
Article
País de afiliação:
Alemanha