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ABSTRACT: Background
Portal vein embolization (PVE) is used before extensive hepatic resections to increase the volume of the future remnant liver within acceptable safety margins (conventionally >0.6% of the patient's weight). The objective was to determine whether pre-operative PVE impacts on post-operative liver function independently from the increase in liver volume.Methods
The post-operative liver function of patients who underwent an anatomical right liver resection with (n = 28) and without (n = 53) PVE were retrospectively analysed. Donors of the right liver were also analysed (LD) (n = 17).Results
Patient characteristics were similar, except for age, weight and American Society of Anesthesiologists (ASA) score that were lower in LD. Post-operative factor V and bilirubin levels were, respectively, higher and lower in patients with PVE compared with patients without PVE or LD (P < 0.05). Patients with PVE had an increased blood loss, blood transfusions and sinusoidal obstruction syndrome. The day-3 bilirubin level was 40% lower in the PVE group compared with the no-PVE group after adjustment for body weight, chemotherapy, operating time, Pringle time, blood transfusions, remnant liver volume, pre-operative bilirubin level and pre-operative prothrombin ratio (P = 0.001).Conclusions
For equivalent volumes, the immediate post-operative hepatic function appears to be better in livers prepared with PVE than in unprepared livers. Future studies should analyse whether the conventional inferior volume limit that allows a safe liver resection may be lowered when a PVE is performed.
SUBMITTER: Meier RP
PROVIDER: S-EPMC4605340 | biostudies-literature | 2015 Nov
REPOSITORIES: biostudies-literature
Meier Raphael P H RP Toso Christian C Terraz Sylvain S Breguet Romain R Berney Thierry T Andres Axel A Jannot Anne-Sophie AS Rubbia-Brandt Laura L Morel Philippe P Majno Pietro E PE
HPB : the official journal of the International Hepato Pancreato Biliary Association 20150908 11
<h4>Background</h4>Portal vein embolization (PVE) is used before extensive hepatic resections to increase the volume of the future remnant liver within acceptable safety margins (conventionally >0.6% of the patient's weight). The objective was to determine whether pre-operative PVE impacts on post-operative liver function independently from the increase in liver volume.<h4>Methods</h4>The post-operative liver function of patients who underwent an anatomical right liver resection with (n = 28) an ...[more]