HO-1 Protects Remnant Liver against Dysfunction after Major Hepatectomy in Humans

2021 ◽  
pp. 1-7
Author(s):  
Ning He ◽  
Xiuni Sun ◽  
Zhenghui Hu ◽  
Feifan Wang ◽  
Yan Zhang ◽  
...  
Keyword(s):  
Major Hepatectomy ◽  
Remnant Liver

scholarly journals Increasing the remnant liver volume using portal vein embolization

2010 ◽  
Vol 4 (5) ◽  
pp. 817-820
Author(s):  
Thanis Saksirinukul ◽  
Permyot Kosolbhand ◽  
Natthaporn Tanpowpong
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Major Hepatectomy ◽  
Liver Volume ◽  
Measurement Methods ◽  
Remnant Liver ◽  
Extended Hepatectomy ◽  
Volumetric Measurement ◽  
Common Procedure ◽  
Total Liver Volume

Abstract Background: Portal vein embolization (PVE) is a common procedure to induce hypertrophy of the remnant liver (RL) before major hepatectomy. Objective: Evaluate increased RL volume after PVE based on CT volumetric measurement. Methods: Multi-detector computed tomography (MDCT) was used to measure hepatic volumetric measurement, including total liver volume and RL volumes of pre- and post-PVE. Complications were recorded from PVE and from three-month after post-extended hepatectomy liver dysfunction. Result and conclusion: There was a 10% increase in RL volume. Mean days between CT and PVE were 20 days. No major complications from PVE were observed.

scholarly journals Preoperative Chemotherapy on Functional Liver Regeneration for Colorectal Liver Metastases Assessed With 99mTc-GSA SPECT/CT Imaging

2018 ◽  
Vol 102 (9-10) ◽  
pp. 431-439 ◽  
Author(s):  
Toru Beppu ◽  
Hiromitsu Hayashi ◽  
Morikatsu Yoshida ◽  
Hidetoshi Nitta ◽  
Katsunori Imai ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Metastases ◽  
Liver Regeneration ◽  
Preoperative Chemotherapy ◽  
Colorectal Liver Metastases ◽  
Major Hepatectomy ◽  
Liver Volume ◽  
Control Group ◽  
Remnant Liver ◽  
Resection Rate

Objective: To investigate the functional liver regeneration after chemotherapy and liver resection for colorectal liver metastases (CRLM). Background/Purpose: Preoperative chemotherapy followed by liver resection for CRLM has been increasing; however, its negative impact on liver regeneration remains unknown. Methods: From January 2009 to December 2013, we enrolled 40 selected patients who underwent major hepatectomy without viral hepatitis and severe liver fibrosis. CRLM patients with preoperative chemotherapy (CT-CRLM group, n = 12) and patients without preoperative chemotherapy (control group, n = 28) were evaluated. Liver volume (LV) and functional liver volume (FLV) was assessed using Tc-99m–labeled galactosyl human serum albumin (99mTc-GSA) scintigraphy, single-photon emission computed tomography (SPECT), CT-fused images. Preoperative, future remnant liver, and post 1-month values were compared. Results: Median course of preoperative chemotherapy was 8 (range: 6–16). Preoperative background factors were almost identical including resection rate and functional resection rate. In the CT-CRLM group and in the control group, the percentage increases in LV were 39.3% ± 29.0% and 23.2% ± 23.5% (P = 0.037), and FLV were 79.4% ± 43.1% and 57.0% ± 33.4% (P = 0.417), respectively; absolute differences in LV were 216.2 ± 155.7 cm3 and 148.7 ± 134.7 cm3 (P = 0.086) and FLV were 19.4% ± 8.5%/m2 and 17.4% ± 7.9%/m2 (P = 0.235), respectively. We found no obvious tendency for negative influence on liver functional regeneration by the preoperative regimens for CRLM. Conclusions: Several courses of preoperative chemotherapy may not affect functional liver regeneration for CRLM patients after major hepatectomy.

scholarly journals The impact of elastography with virtual touch quantification of future remnant liver before major hepatectomy

2021 ◽  
Vol 11 (6) ◽  
pp. 2572-2585
Author(s):  
Shingo Shimada ◽  
Toshiya Kamiyama ◽  
Tatsuhiko Kakisaka ◽  
Tatsuya Orimo ◽  
Akihisa Nagatsu ◽  
...  
Keyword(s):  
Major Hepatectomy ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
The Impact

Darbepoetin-α Promotes Cell Proliferation in Established Extrahepatic Colorectal Tumors after Major Hepatectomy

2015 ◽  
Vol 56 (1-2) ◽  
pp. 49-60
Author(s):  
Sebastian Senger ◽  
Otto Kollmar ◽  
Michael D. Menger ◽  
Kathrin Rupertus
Keyword(s):  
Cell Proliferation ◽  
Cell Migration ◽  
Liver Metastasis ◽  
Tumor Cell ◽  
Colorectal Liver Metastasis ◽  
Major Hepatectomy ◽  
Colorectal Metastases ◽  
Remnant Liver ◽  
Tumor Cell Proliferation ◽  
Tumor Cell Migration

Background: The glycoprotein hormone erythropoietin and its analogue darbepoetin-α (DPO) have been shown to reduce the risk of acute liver failure after major hepatectomy. However, previous experimental studies have also shown that DPO significantly enhances neovascularization and tumor cell proliferation in established colorectal liver metastasis in hepatectomized and nonhepatectomized mice. The present study now analyzes whether DPO influences cell proliferation and migration as well as vascularization and growth of established colorectal metastasis at extrahepatic sites after major hepatectomy. Methods: GFP-transfected CT26.WT colorectal cancer cells were implanted into dorsal skinfold chambers of syngeneic BALB/c mice. Five days after tumor cell implantation, the animals received a single dose of DPO (10 µg/kg body weight) or phosphate-buffered saline solution (PBS) intravenously. Additional animals received a 70% hepatectomy and DPO or PBS treatment. Tumor vascularization and growth as well as tumor cell migration, proliferation and apoptosis were studied repetitively over 14 days using intravital fluorescence microscopy, histology and immunohistochemistry. Results: DPO did not influence tumor cell migration and apoptosis. In addition, DPO did not stimulate tumor cell infiltration or vascularization; however, significantly increased tumor cell proliferation was detected in hepatectomized animals. Conclusion: DPO increases cell proliferation in established extrahepatic colorectal metastases after major hepatectomy. Thus, DPO may not be recommended to stimulate regeneration of the remnant liver after major hepatectomy for colorectal liver metastasis.

Mo2031 The Importance of Portal Vein Embolization Before Major Hepatectomy for Patients With Predicted Insufficiency of the Remnant Liver

2013 ◽  
Vol 144 (5) ◽  
pp. S-723
Author(s):  
Yoshikazu Toyoki ◽  
Keinosuke Ishido ◽  
Daisuke Kudo ◽  
Norihisa Kimura ◽  
Shinnosuke Yonaiyama ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Major Hepatectomy ◽  
Remnant Liver

scholarly journals Technique of vessel-skeletonized parenchyma-sparing hepatectomy for the oncological treatment of bilobar colorectal liver metastases

2021 ◽  
Author(s):  
Yuzo Umeda ◽  
Takeshi Nagasaka ◽  
Kosei Takagi ◽  
Ryuichi Yoshida ◽  
Kazuhiro Yoshida ◽  
...  
Keyword(s):  
Adjuvant Chemotherapy ◽  
Liver Metastases ◽  
Colorectal Liver Metastases ◽  
Major Hepatectomy ◽  
Surgical Navigation ◽  
Median Number ◽  
Remnant Liver ◽  
Oncological Treatment ◽  
Significant Difference ◽  
Parenchyma Sparing

Abstract Background To aid in the oncological management of multiple bilobar colorectal liver metastases (CRLMs), we describe a new surgical procedure, VEssel-Skeletonized PArenchyma-sparing Hepatectomy (VESPAH). Study design Of 152 patients with CRLMs treated with hepatectomy, 33 patients had multiple bilobar liver metastases (≥8 liver metastases); their surgical procedures and clinical outcomes were retrospectively summarized and compared between those who underwent VESPAH and those who underwent major hepatectomy (Major Hx). Results Of the 33 patients, 20 patients were resected by VESPAH (the VESPAH group) and 13 patients by major hepatectomy (Major Hx group). The median number of CRLMs was 13 (range, 8–53) in the VESPAH group and 10 (range, 8–41) in the Major Hx group (P=0.511). No operative mortality nor severe morbidity was observed in either group. The VESPAH group showed earlier recovery of remnant liver function after surgery than the Major Hx group; the incidence of grade B/C post hepatectomy liver failure was 5% in the VESPAH group and 38% in the Major Hx group, P=0.048). Intrahepatic tumor recurrence was confirmed in 14 (70%) and 7 (54%) patients in the VESPAH and Major Hx groups, respectively (P=0.416). There was no significant difference in median overall survival (OS) after hepatectomy between the two groups; the median OS was 47 months in the VESPAH group and 33 months in the Major Hx group (P=0.481). The VESPAH group showed the higher induction rate of adjuvant chemotherapy within 2 months after surgery (P=0.002) and total number of repeat hepatectomy for intrahepatic recurrence (P=0.060) than the Major Hx group. Conclusions VESPAH enables us to clear surgical navigation by hepatic vessel skeletonization and may enhance patient tolerability of not only adjuvant chemotherapy but also repeat hepatectomies during the patients’ lifetimes.

Significance of the Effective Remnant Liver Volume in Major Hepatectomies

2005 ◽  
Vol 71 (3) ◽  
pp. 235-240 ◽  
Author(s):  
Salvatore Gruttadauria ◽  
Fabio Vasta ◽  
Marta Ida Minervini ◽  
Tommaso Piazza ◽  
Antonio Arcadipane ◽  
...  
Keyword(s):  
Major Hepatectomy ◽  
Frozen Section ◽  
Liver Volume ◽  
Postoperative Mortality ◽  
Liver Function Tests ◽  
Chronic Viral Hepatitis ◽  
Remnant Liver ◽  
Total Liver Volume ◽  
Remnant Liver Volume ◽  
Major Hepatectomies

The aim of this study is to identify the minimum safe amount of effective remnant liver volume (ERLV) in patients undergoing a major hepatectomy. Thirty-eight consecutive major hepatectomies (resection of ≥3 Couinaud segments) performed between July 1999 and March 2004 in which a frozen section liver biopsy was obtained were included. No patient had chronic viral hepatitis, cirrhosis, or cholestasis. The total liver volume (TLV) was calculated using the Vauthey formula, and the postsurgical liver volume (PSLV) was derived by subtracting the estimated volume of liver resected from the TLV. The PSLV minus the percentage of macrovesicular steatosis as nonfunctional liver was defined as the effective remnant liver volume (ERLV). Three groups of ERLV/TLV ratios (<30%, between 30% and 60%, and >60%) were correlated with liver resection type, mortality, complications, intraoperative blood transfusions, operative time, length of hospitalization, and mean value of liver function tests in the first 5 postoperative days. Comparisons between clinical parameters were performed by Pearson χ2 test. There was significant correlation between ERLV/TLV ratios and surgical resection type ( P < 0.001), early postoperative mortality ( P < 0.01), and complications ( P < 0.003). The ERLV/TLV ratio may be a useful predictor of surgical outcome after major hepatectomy.

The Assessment of Regional Liver Function Before Major Hepatectomy Using Magnetic Resonance Imaging

2021 ◽  
pp. 000313482110110
Author(s):  
Masashi Kudo ◽  
Naoto Gotohda ◽  
Motokazu Sugimoto ◽  
Masaru Konishi ◽  
Shinichiro Takahashi ◽  
...  
Keyword(s):  
Liver Function ◽  
Signal Intensity ◽  
Intensity Ratio ◽  
Major Hepatectomy ◽  
Volumetric Analysis ◽  
Remnant Liver ◽  
Signal Intensity Ratio ◽  
Future Remnant Liver ◽  
The Future ◽  
Liver Region

Background The liver-to-spleen signal intensity ratio (LSR) on magnetic resonance imaging with gadolinium-ethoxybenzyl-diethylenetriamine pentaacetic acid has been used as a parameter to assess liver function. LSR of the future remnant liver region (FR-LSR) is included in preoperative assessment of regional liver function. The aim of this study was to investigate the predictability of post-hepatectomy liver failure (PHLF) by FR-LSR. Methods Between May 2013 and May 2019, 127 patients underwent standardized EOB-MRI for diagnosis of liver tumor before major hepatectomy. The FR-LSR on EOB-MRI was calculated by a semiautomated three-dimensional volumetric analysis system. The cutoff value of FR-LSR in association with clinically relevant PHLF was determined according to the areas under the receiver operating characteristic curves. Then, FR-LSR and clinical variables were analyzed to assess the risk of clinically relevant PHLF. Results In patients with preoperative biliary drainage, metastatic liver tumor, estimated future remnant liver volume <50%, biliary reconstruction, operation time ≥ 480 min, estimated blood loss ≥ 1000 g, blood transfusion and a FR-LSR < 2.00 were associated with clinically relevant PHLF ( P < .05 for all) in univariable analysis. The liver-to-spleen signal intensity ratio of the future remnant liver region < 2.00 was the only independent risk factor for clinically relevant PHLF in multivariable risk analysis (OR, 27.90; 95% CI: 7.99-136.40; P < .05). Discussion The present study revealed that FR-LSR calculated using a 3-dimensional volumetric analysis system was an independent risk factor for clinically relevant PHLF. The liver-to-spleen signal intensity ratio of the future remnant liver region might be a reliable preoperative parameter in liver functional assessment, enabling safe performance of major hepatectomy.

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