Predicting liver failure after extended right hepatectomy following right portal vein embolization with gadoxetic acid-enhanced MRI

2019 ◽  
Vol 29 (11) ◽  
pp. 5861-5872 ◽  
Author(s):  
Dorothea Theilig ◽  
Ingo Steffen ◽  
Maciej Malinowski ◽  
Martin Stockmann ◽  
Daniel Seehofer ◽  
...  
Keyword(s):  
Portal Vein ◽  
Liver Failure ◽  
Portal Vein Embolization ◽  
Gadoxetic Acid ◽  
Right Hepatectomy ◽  
Enhanced Mri ◽  
Extended Right Hepatectomy

scholarly journals Oncological Outcomes after Liver Venous Deprivation for Colorectal Liver Metastases: A Single Center Experience

Cancers ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 200
Author(s):  
Salah Khayat ◽  
Gianluca Cassese ◽  
François Quenet ◽  
Christophe Cassinotto ◽  
Eric Assenat ◽  
...  
Keyword(s):  
Portal Vein ◽  
Liver Metastases ◽  
Portal Vein Embolization ◽  
Colorectal Liver Metastases ◽  
Future Liver Remnant ◽  
Small Sample ◽  
Right Hepatectomy ◽  
Liver Remnant ◽  
Oncological Outcomes ◽  
Extended Right Hepatectomy

Colorectal liver metastases (CRLM) are the major cause of death in patients with colorectal cancer (CRC). The cornerstone treatment of CRLM is surgical resection. Post-operative morbidity and mortality are mainly linked to an inadequate future liver remnant (FLR). Nowadays preoperative portal vein embolization (PVE) is the most widely performed technique to increase the size of the future liver remnant (FLR) before major hepatectomies. One method recently proposed to increase the FLR is liver venous deprivation (LVD), but its oncological impact is still unknown. The aim of this study is to report first short- and long-term oncological outcomes after LVD in patients undergoing right (or extended right) hepatectomy for CRLM. Seventeen consecutive patients undergoing LVD between July 2015 and May 2020 before an (extended) right hepatectomy were retrospectively analyzed from an institutional database. Post-operative and follow-up data were analyzed and reported. Primary outcomes were 1-year and 3-year overall survival (OS) and hepatic recurrence (HR). Postoperative complications occurred in 8 patients (47%). No deaths occurred after surgery. HR occurred in 9 patients (52.9%). 1-year and 3-year OS were 87% (95% confidence interval [CI]: ±16%) and 60.3%, respectively (95% CI: ±23%). Median Disease-Free Survival (DFS) was 6 months (CI 95%: 4.7–7.2). With all the limitations of a retrospective study with a small sample size, LVD showed similar oncological outcomes compared to literature reports for Portal Vein Embolization (PVE).

scholarly journals A Comparison of Portal Vein Embolization With Poly(2-hydroxyethylmethacrylate) and a Histoacryl/Lipiodol Mixture in Patients Scheduled for Extended Right Hepatectomy

2015 ◽  
pp. 841-848 ◽  
Author(s):  
J. H. PEREGRIN ◽  
R. JANOUŠEK ◽  
D. KAUTZNEROVÁ ◽  
M. OLIVERIUS ◽  
E. STICOVÁ ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Right Hepatectomy ◽  
Portal Vein Branch ◽  
Liver Remnant ◽  
Extended Right Hepatectomy ◽  
The Right ◽  
Transhepatic Access ◽  
Flr Hypertrophy

ght hepatectomy and whether it is as effective as the currently used agent (a histoacryl/lipiodol mixture). Two groups of nine patients each scheduled for extended right hepatectomy for primary or secondary hepatic tumor, had right portal vein embolization in an effort to induce future liver remnant (FLR) hypertrophy. One group had embolization with PHEMA, the other one with the histoacryl/lipiodol mixture. In all patients, embolization was performed using the right retrograde transhepatic access. Embolization was technically successful in all 18 patients, with no complication related to the embolization agent. Eight patients of either group developed FLR hypertrophy allowing extended right hepatectomy. Likewise, one patient in each group had recanalization of a portal vein branch. Histology showed that both embolization agents reach the periphery of portal vein branches, with PHEMA penetrating somewhat deeper into the periphery. PHEMA has been shown to be an agent suitable for embolization in the portal venous system comparable with existing embolization agent (histoacryl/lipiodol mixture).

Infusion of CD133+ Bone Marrow–Derived Stem Cells After Selective Portal Vein Embolization Enhances Functional Hepatic Reserves After Extended Right Hepatectomy

2012 ◽  
Vol 255 (1) ◽  
pp. 79-85 ◽  
Author(s):  
Jan Schulte am Esch ◽  
Moritz Schmelzle ◽  
Günther Fürst ◽  
Simon C. Robson ◽  
Andreas Krieg ◽  
...  
Keyword(s):  
Stem Cells ◽  
Bone Marrow ◽  
Portal Vein ◽  
Portal Vein Embolization ◽  
Right Hepatectomy ◽  
Extended Right Hepatectomy

scholarly journals Safety and efficacy of preoperative right portal vein embolization in patients at risk for postoperative liver failure following major right hepatectomy

HPB ◽  
2012 ◽  
Vol 14 (1) ◽  
pp. 14-19 ◽  
Author(s):  
Kristen P. Massimino ◽  
Kenneth J. Kolbeck ◽  
C. Kristian Enestvedt ◽  
Susan Orloff ◽  
Kevin G. Billingsley
Keyword(s):  
At Risk ◽  
Portal Vein ◽  
Liver Failure ◽  
Portal Vein Embolization ◽  
Postoperative Liver Failure ◽  
Right Hepatectomy ◽  
Safety And Efficacy ◽  
Patients At Risk

scholarly journals Volume Change and Liver Parenchymal Signal Intensity in Gd-EOB-DTPA-Enhanced Magnetic Resonance Imaging after Portal Vein Embolization prior to Hepatectomy

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Ayako Akiba ◽  
Satoru Murata ◽  
Takahiko Mine ◽  
Shiro Onozawa ◽  
Tetsuro Sekine ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Portal Vein ◽  
Volume Change ◽  
Portal Vein Embolization ◽  
Liver Volume ◽  
Resonance Imaging ◽  
Ct Volumetry ◽  
Liver Remnant ◽  
Enhanced Mri

Purpose.To investigate the liver volume change and the potential of early evaluation by contrast-enhanced magnetic resonance imaging (MRI) using gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid (Gd-EOB-DTPA) after portal vein embolization (PVE).Materials and Methods.Retrospective evaluations of computed tomography (CT) volumetry of total liver and nonembolized areas were performed before and 3 weeks after PVE in 37 cases. The percentage of future liver remnant (%FLR) and the change ratio of %FLR (%FLR ratio) were calculated. Prospective evaluation of signal intensities (SIs) was performed to estimate the role of Gd-EOB-DTPA-enhanced MRI as a predictor of hypertrophy in 16 cases. The SI contrast between embolized and nonembolized areas was calculated 1 week after PVE. The change in SI contrast before and after PVE (SI ratio) was also calculated in 11 cases.Results.%FLR ratio significantly increased, and SI ratio significantly decreased (bothP<0.01). There were significant negative correlations between %FLR and SI contrast and between %FLR and SI ratio (bothP<0.01).Conclusion.Hypertrophy in the nonembolized area after PVE was indicated by CT volumetry, and measurement of SI contrast and SI ratio in Gd-EOB-DTPA-enhanced MRI early after PVE may be useful to predict the potential for hepatic hypertrophy.

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