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Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant
BACKGROUND: Preoperative portal vein embolization (PVE) is widely used prior to major liver resection to reduce the risk of post-hepatectomy liver failure (PHLF). We evaluated the efficacy and safety of PVE using absolute ethanol. METHODS: Consecutive patients undergoing preoperative PVE between Feb...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer International Publishing
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307697/ https://www.ncbi.nlm.nih.gov/pubmed/35869399 http://dx.doi.org/10.1186/s42155-022-00312-3 |
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author | Santhakumar, Cositha Ormiston, William McCall, John L Bartlett, Adam Duncan, David Holden, Andrew |
author_facet | Santhakumar, Cositha Ormiston, William McCall, John L Bartlett, Adam Duncan, David Holden, Andrew |
author_sort | Santhakumar, Cositha |
collection | PubMed |
description | BACKGROUND: Preoperative portal vein embolization (PVE) is widely used prior to major liver resection to reduce the risk of post-hepatectomy liver failure (PHLF). We evaluated the efficacy and safety of PVE using absolute ethanol. METHODS: Consecutive patients undergoing preoperative PVE between February 2003 and February 2020 at a high-volume tertiary institution were retrospectively reviewed. Hypertrophy of the future liver remnant (FLR) was determined by comparing volumetric data using semi-automated software on computed tomography or magnetic resonance imaging before and after PVE. Efficacy of absolute ethanol was evaluated by the percentage increase in the FLR volume and the ratio of the FLR to the total liver volume (TLV). Technical success and complications following PVE were evaluated. Feasibility of hepatectomy following PVE and the incidence of PHLF were determined. RESULTS: Sixty-two patients underwent preoperative PVE using absolute ethanol. The technical success rate was 95.2%. Median time interval between PVE and follow-up imaging was 34 days (range 6–144 days). The mean increase in FLR volume and ratio of the FLR to TLV were 43.6 ± 34.4% and 12.3 ± 7.7% respectively. Major adverse events occurred in 3 cases (4.8%) and did not preclude consideration of surgery. Forty-two patients (67.8%) proceeded to surgery for intended hepatectomy of which 36 patients (58.1%) underwent liver resection. Major post-operative complications occurred in 4 patients (11.1%) and there were no cases of PHLF. CONCLUSION: Preoperative PVE with absolute ethanol is effective and safe in inducing hypertrophy of the FLR before partial hepatectomy to prevent PHLF. |
format | Online Article Text |
id | pubmed-9307697 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer International Publishing |
record_format | MEDLINE/PubMed |
spelling | pubmed-93076972022-07-24 Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant Santhakumar, Cositha Ormiston, William McCall, John L Bartlett, Adam Duncan, David Holden, Andrew CVIR Endovasc Original Article BACKGROUND: Preoperative portal vein embolization (PVE) is widely used prior to major liver resection to reduce the risk of post-hepatectomy liver failure (PHLF). We evaluated the efficacy and safety of PVE using absolute ethanol. METHODS: Consecutive patients undergoing preoperative PVE between February 2003 and February 2020 at a high-volume tertiary institution were retrospectively reviewed. Hypertrophy of the future liver remnant (FLR) was determined by comparing volumetric data using semi-automated software on computed tomography or magnetic resonance imaging before and after PVE. Efficacy of absolute ethanol was evaluated by the percentage increase in the FLR volume and the ratio of the FLR to the total liver volume (TLV). Technical success and complications following PVE were evaluated. Feasibility of hepatectomy following PVE and the incidence of PHLF were determined. RESULTS: Sixty-two patients underwent preoperative PVE using absolute ethanol. The technical success rate was 95.2%. Median time interval between PVE and follow-up imaging was 34 days (range 6–144 days). The mean increase in FLR volume and ratio of the FLR to TLV were 43.6 ± 34.4% and 12.3 ± 7.7% respectively. Major adverse events occurred in 3 cases (4.8%) and did not preclude consideration of surgery. Forty-two patients (67.8%) proceeded to surgery for intended hepatectomy of which 36 patients (58.1%) underwent liver resection. Major post-operative complications occurred in 4 patients (11.1%) and there were no cases of PHLF. CONCLUSION: Preoperative PVE with absolute ethanol is effective and safe in inducing hypertrophy of the FLR before partial hepatectomy to prevent PHLF. Springer International Publishing 2022-07-23 /pmc/articles/PMC9307697/ /pubmed/35869399 http://dx.doi.org/10.1186/s42155-022-00312-3 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Article Santhakumar, Cositha Ormiston, William McCall, John L Bartlett, Adam Duncan, David Holden, Andrew Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title | Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title_full | Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title_fullStr | Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title_full_unstemmed | Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title_short | Portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
title_sort | portal vein embolization with absolute ethanol to induce hypertrophy of the future liver remnant |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9307697/ https://www.ncbi.nlm.nih.gov/pubmed/35869399 http://dx.doi.org/10.1186/s42155-022-00312-3 |
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