Article Sidebar

PDF (Tiếng Việt)
Published: 2023-10-30
Abstract Views: 267
Views PDF (Tiếng Việt): 487
DOI: https://doi.org/10.52852/tcncyh.v170i9.1934
Issue
Vol. 170 No. 9 (2023)
Section
Các bài báo
How to Cite
Sỹ, T. V., Dũng, L. T., Thấu, C. M., An, P. G., Nghĩa, N. Q., Khải, N. V., Phương, T. H., Nam, N. H., Thơ, T. Đình, Sơn, T. H., Giang, B. V., Châu, T. H., Lưu, V. Đăng, & Thông, P. M. (2023). 22. Results of increasing the future liver remnant volume after portal and hepatic vein embolization in hepatocellular carcinoma. Journal of Medical Research, 170(9), 195-204. https://doi.org/10.52852/tcncyh.v170i9.1934

22. Results of increasing the future liver remnant volume after portal and hepatic vein embolization in hepatocellular carcinoma

Than Van Sy, Le Thanh Dung, Cao Manh Thau, Pham Gia An, Nguyen Quang Nghia, Ninh Viet Khai, Tran Ha Phuong, Nguyen Hai Nam, Tran Dinh Tho, Trinh Hong Son, Bui Van Giang, Trinh Ha Chau, Vu Dang Luu, Pham Minh Thong

Main Article Content

Abstract

The purpose of this study was to evaluate the portal and hepatic vein embolization (LVD) outcome before hepatectomy in patients with hepatocellular carcinoma (HCC). From January 2021 to July 2023, 52 HCC patients (median age of 54.5) with indication for hepatectomy but inadequate initial future liver remnant (FLR) underwent LVD to increase FLR before surgery. Technical success was obtained in all cases. After the LVD, all patients obtained sufficient FLR for surgery. The FLR volume before and after LVD was 405.1 ml and 639.5 ml, respectively (p < 0.001). The percentage of FLR of total liver volume (TLV) increased from 34.0% to 47.4% (p < 0.001), with the percentage of hypertrophy (FLRpost/FLRpre) reaching 1.5 times. One case presented with grade A liver failure after LVD but recovered after 7 days. LVD is a safe, effective and feasible method to increase FLR in HCC patients significantly. Randomized controlled clinical trials are needed to evaluate the efficacy of LVD and to compare with other methods.

Article Details

Keywords

Portal vein embolization, hepatic vein embolization, liver hypertrophy, hepatocellular carcinoma

References

1. Schreckenbach T, Liese J, Bechstein WO, Moench C. Posthepatectomy liver failure. Digestive surgery. 2012; 29(1): 79-85.
2. Cieslak KP, Runge JH, Heger M, Stoker J, Bennink RJ, Van Gulik TM. New perspectives in the assessment of future remnant liver. Digestive Surgery. 2015; 31(4-5): 255-268.
3. Lafaro K, Buettner S, Maqsood H, et al. Defining post hepatectomy liver insufficiency: where do we stand? Journal of Gastrointestinal Surgery. 2015; 19:2079-2092.
4. Müller PC, Linecker M, Kirimker EO, et al. Induction of liver hypertrophy for extended liver surgery and partial liver transplantation: State of the art of parenchyma augmentation–assisted liver surgery. Langenbeck’s Archives of Surgery. Published online 2021: 1-15.
5. Kim D, Cornman-Homonoff J, Madoff DC. Preparing for liver surgery with “Alphabet Soup”: PVE, ALPPS, TAE-PVE, LVD and RL. Hepatobiliary surgery and nutrition. 2020; 9(2): 136.
6. Huang SY, Aloia TA. Portal vein embolization: state-of-the-art technique and options to improve liver hypertrophy. Visceral medicine. 2017; 33(6): 419-425.
7. Lê Thanh Dũng. Nghiên cứu áp dụng và đánh giá hiệu quả của phương pháp nút nhánh tĩnh mạch cửa gây phì đại gan trước phẫu thuật cắt gan. Luận án Tiến sĩ Y học. Đại học Y Hà Nội; 2018.
8. Alvarez FA, Castaing D, Figueroa R, et al. Natural history of portal vein embolization before liver resection: a 23-year analysis of intention-to-treat results. Surgery. 2018; 163(6): 1257-1263.
9. Laurent C, Fernandez B, Marichez A, et al. Radiological simultaneous portohepatic vein embolization (RASPE) before major hepatectomy: a better way to optimize liver hypertrophy compared to portal vein embolization. Annals of Surgery. 2020; 272(2): 199-205.
10. Le Roy B, Gallon A, Cauchy F, et al. Combined biembolization induces higher hypertrophy than portal vein embolization before major liver resection. HPB. 2020; 22(2): 298-305.
11. Guiu B, Quenet F, Escal L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function. European radiology. 2017; 27(8): 3343-3352.
12. Esposito F, Lim C, Lahat E, et al. Combined hepatic and portal vein embolization as preparation for major hepatectomy: a systematic review. HPB. 2019; 21(9): 1099-1106.
13. Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surgery and Nutrition. 2020; 9(5): 564.
14. Glantzounis GK, Karampa A, Peristeri D. Radiological simultaneous portohepatic vein embolization (RASPE) and major hepatectomy with hepatocellular carcinoma (HCC). Hepatobiliary Surgery and Nutrition. 2021; 10(2): 267.
15. Božin T, Mustapić S, Bokun T, et al. Albi score as a predictor of survival in patients with compensated cirrhosis resected for hepatocellular carcinoma: Exploratory evaluation in relationship to palbi and meld liver function scores. Acta Clinica Croatica. 2018; 57(2.): 292-300.
16. Le Roy B, Dupré A, Gallon A, Chabrot P, Gagnière J, Buc E. Liver hypertrophy: Underlying mechanisms and promoting procedures before major hepatectomy. Journal of visceral surgery. 2018; 155(5): 393-401.
17. Degrauwe N, Duran R, Melloul E, Halkic N, Demartines N, Denys A. Induction of robust future liver remnant hypertrophy before hepatectomy with a modified liver venous deprivation technique using a trans-venous access for hepatic vein embolization. Frontiers in Radiology. 2021; 1:736056.