Anatomical, Physiological, and Kinetic Evaluation of the Future Liver Remnant of CRLM After Portal Vein Embolisation

2019 ◽  
pp. 173-183
Author(s):  
D. Asano ◽  
D. Ban ◽  
M. Tanabe
Keyword(s):  
Portal Vein ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Kinetic Evaluation ◽  
Portal Vein Embolisation ◽  
The Future

scholarly journals Successful Thrombectomy via a Surgically Reopened Umbilical Vein for Extended Portal Vein Thrombosis Caused by Portal Vein Embolization prior to Extended Liver Resection

2020 ◽  
Vol 14 (2) ◽  
pp. 320-328
Author(s):  
Wouter J.M. Derksen ◽  
Iris E.M. de Jong ◽  
Carlijn I. Buis ◽  
Koen M.E.M. Reyntjens ◽  
G. Matthijs Kater ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Thrombosis ◽  
Portal Vein Embolization ◽  
Liver Surgery ◽  
Umbilical Vein ◽  
Future Liver Remnant ◽  
Main Stem ◽  
Liver Remnant ◽  
Vein Thrombosis ◽  
The Future

Selective portal vein embolization (PVE) before extended liver surgery is an accepted method to stimulate growth of the future liver remnant. Portal vein thrombosis (PVT) of the main stem and the non-targeted branches to the future liver remnant is a rare but major complication of PVE, requiring immediate revascularization. Without revascularization, curative liver surgery is not possible, resulting in a potentially life-threatening situation. We here present a new surgical technique to revascularize the portal vein after PVT by combining a surgical thrombectomy with catheter-based thrombolysis via the surgically reopened umbilical vein. This technique was successfully applied in a patient who developed thrombosis of the portal vein main stem, as well as the left portal vein and its branches to the left lateral segments after selective right-sided PVE in preparation for an extended right hemihepatectomy. The advantage of this technique is the avoidance of an exploration of hepatoduodenal ligament and a venotomy of the portal vein. The minimal surgical trauma facilitates additional intravascular thrombolytic therapy as well as the future right extended hemihepatectomy. We recommend this technique in patients with extensive PVT in which percutaneous less invasive therapies have been proven unsuccessful.

Trans-Splenic Portal Vein Embolization: A Technique to Avoid Damage to the Future Liver Remnant

2016 ◽  
Vol 39 (10) ◽  
pp. 1514-1518 ◽  
Author(s):  
Ammar Sarwar ◽  
Olga R. Brook ◽  
Jeffrey L. Weinstein ◽  
Khalid Khwaja ◽  
Muneeb Ahmed
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
The Future

scholarly journals Predictive Factors for Hypertrophy of the Future Liver Remnant After Portal Vein Embolization: A Systematic Review

2021 ◽  
Author(s):  
E. A. Soykan ◽  
B. M. Aarts ◽  
M. Lopez-Yurda ◽  
K. F. D. Kuhlmann ◽  
J. I. Erdmann ◽  
...  
Keyword(s):  
Systematic Review ◽  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
The Future ◽  
Quantitative Synthesis ◽  
Neo Adjuvant Chemotherapy ◽  
Meta Analyses ◽  
Subsequent Literature

AbstractThis systematic review was conducted to determine factors that are associated with the degree of hypertrophy of the future liver remnant following portal vein embolization. An extensive search on September 15, 2020, and subsequent literature screening resulted in the inclusion of forty-eight articles with 3368 patients in qualitative analysis, of which 18 studies were included in quantitative synthesis. Meta-analyses based on a limited number of studies showed an increase in hypertrophy response when additional embolization of segment 4 was performed (pooled difference of medians = − 3.47, 95% CI − 5.51 to − 1.43) and the use of N-butyl cyanoacrylate for portal vein embolization induced more hypertrophy than polyvinyl alcohol (pooled standardized mean difference (SMD) = 0.60, 95% CI 0.30 to 0.91). There was no indication of a difference in degree of hypertrophy between patients who received neo-adjuvant chemotherapy and those who did not receive pre-procedural systemic therapy(pooled SMD = − 0.37, 95% CI − 1.35 to 0.61), or between male and female patients (pooled SMD = 0.19, 95% CI − 0.12 to 0.50).The study was registered in the International Prospective Register of Systematic Reviews on April 28, 2020 (CRD42020175708).

scholarly journals Additional partial hepatectomy at the time of portal vein ligation accelerates the regeneration of the future liver remnant

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chuanfeng Hua ◽  
Weiwei Wei ◽  
Tianjiao Zhang ◽  
Fengming Xu ◽  
Olaf Dirsch ◽  
...  
Keyword(s):  
Portal Vein ◽  
Mrna Expression ◽  
Future Liver Remnant ◽  
Hepatocyte Proliferation ◽  
Nuclear Antigen ◽  
Proliferation Index ◽  
Portal Vein Ligation ◽  
Liver Remnant ◽  
The Future ◽  
Additional Resection

AbstractPortal vein ligation (PVL) has been adopted to induce hypertrophy of the future liver remnant (FLR) in patients with primarily irresectable liver tumor. However, regeneration of the FLR is not always sufficient to allow curative resection of the portally-deprived tumor-bearing liver lobe. We hypothesize that simultaneous hepatectomy (PHx) and PVL augments regeneration of the FLR and that the effect is related to the extent of the additional resection. Seventy-two Lewis rats were enrolled into 3 groups: 20%PVL + 70%PHx; 70%PVL + 20%PHx; 90%PVL. Animals were observed for 1, 2, 3 and 7 days postoperatively (n = 6/time point). Liver enzymes, caudate liver/body-weight-ratio, BrdU-proliferation-index (PI), proliferating-cell-nuclear-antigen (PCNA)-mRNA-expression level and autophagy-related-proteins were evaluated. Compared with 90% PVL, additional PHx induced significantly more hypertrophy during the observation time, which was confirmed by significantly higher PI and higher level of PCNA-mRNA expression. Similarly, the additional PHx induced more autophagy in the FLR compared with PVL alone. However, both effects were not clearly related to the extent of additional resection. Additional resection augmented liver regeneration and autophagy substantially compared with PVL alone. Therefore, we concluded that autophagy might play a critical role in regulating hepatocyte proliferation and the size of the FLR after simultaneous PVL + PHx.

In situliver transection with portal vein ligation for rapid growth of the future liver remnant in two-stage liver resection

2012 ◽  
Vol 100 (3) ◽  
pp. 388-394 ◽  
Author(s):  
W. T. Knoefel ◽  
I. Gabor ◽  
A. Rehders ◽  
A. Alexander ◽  
M. Krausch ◽  
...  
Keyword(s):  
Liver Resection ◽  
Portal Vein ◽  
Rapid Growth ◽  
Future Liver Remnant ◽  
Portal Vein Ligation ◽  
Two Stage ◽  
Liver Remnant ◽  
The Future
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