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 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 Factors influencing hypertrophy of the future liver remnant volume after portal vein embolization

HPB ◽  
2016 ◽  
Vol 18 ◽  
pp. e309
Author(s):  
K. Fukase ◽  
S. Maeda ◽  
K. Kawaguchi ◽  
K. Masuda ◽  
H. Ohtsuka ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Factors Influencing ◽  
The Future ◽  
Future Liver Remnant Volume ◽  
Liver Remnant Volume

scholarly journals Identification of cofactors influencing hypertrophy of the future liver remnant after portal vein embolization—the effect of collaterals on embolized liver volume

2016 ◽  
Vol 89 (1068) ◽  
pp. 20160306 ◽  
Author(s):  
Martin Zeile ◽  
Artur Bakal ◽  
Jan E Volkmer ◽  
Gregor A Stavrou ◽  
Philip Dautel ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Liver Volume ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
The Future

Portal vein embolization with n-butyl-cyanoacrylate before hepatectomy: a single-center retrospective analysis of 46 consecutive patients

2020 ◽  
pp. 028418512095380
Author(s):  
Marijela Moreno Berggren ◽  
Bengt Isaksson ◽  
Rickard Nyman ◽  
Charlotte Ebeling Barbier
Keyword(s):  
Liver Resection ◽  
Portal Vein ◽  
Local Anesthesia ◽  
Portal Vein Embolization ◽  
Liver Tumors ◽  
Future Liver Remnant ◽  
Liver Remnant ◽  
Total Liver Volume ◽  
Computed Tomography Images ◽  
The Future

Background Preoperative portal vein embolization (PVE) is performed to induce hypertrophy of the future liver remnant enabling major liver resection in patients with various types of liver tumors. Purpose To evaluate safety and effectiveness of PVE with n-butyl-cyanoacrylate (NBCA). Material and Methods All consecutive patients referred to our hospital for PVE between July 2006 and July 2017 were retrospectively reviewed. Volumetry was performed on computed tomography images before and after PVE, segmenting the total liver volume and the future liver remnant (FLR), i.e. liver segments I–III. Results PVE was performed in 46 patients (18 women, 28 men; mean age = 61 years) using local anesthesia. The ipsilateral technique was used in 45 patients. Adverse events were rare. The mean FLR volume increase was 56%, the degree of hypertrophy was 9.7%, and the kinetic growth rate was 2.1%/week. The median ± SD period between PVE and liver surgery was 7 ± 3 weeks. Forty-two patients (91%) had surgery; liver resection was performed in 37 (80%) patients. Three patients (7%) developed transient liver failure after surgery. There was no 90-day post-PVE or postoperative mortality. Conclusion PVE using NBCA through the ipsilateral approach in local anesthesia is safe and effective in inducing hypertrophy of the future liver remnant enabling surgery, and thereby increasing survival in patients with liver tumors.

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