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

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.

A New Proposal of Criteria for the Future Remnant Liver Volume in Older Patients Undergoing Major Hepatectomy for Biliary Tract Cancer

2018 ◽  
Vol 267 (2) ◽  
pp. 338-345 ◽  
Author(s):  
Yoshihiro Watanabe ◽  
Satoshi Kuboki ◽  
Hiroaki Shimizu ◽  
Masayuki Ohtsuka ◽  
Hideyuki Yoshitomi ◽  
...  
Keyword(s):  
Biliary Tract ◽  
Biliary Tract Cancer ◽  
Older Patients ◽  
Major Hepatectomy ◽  
Liver Volume ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
Tract Cancer ◽  
Remnant Liver Volume ◽  
The Future

Successful treatment of conversion chemotherapy for initially unresectable synchronous colorectal liver metastasis

2020 ◽  
Author(s):  
Lungwani Muungo
Keyword(s):  
Liver Metastasis ◽  
Colorectal Liver Metastasis ◽  
Surgical Intervention ◽  
Liver Volume ◽  
Sigmoid Colon Cancer ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
The Right ◽  
Synchronous Colorectal Liver Metastasis ◽  
Right Hepatic Vein

A 72-year-old woman with a sigmoid colon cancer anda synchronous colorectal liver metastasis (CRLM), whichinvolved the right hepatic vein (RHV) and the inferiorvena cava (IVC), was referred to our hospital. Themetastatic lesion was diagnosed as initially unresectablebecause of its invasion into the confluence of theRHV and IVC. After she had undergone laparoscopicsigmoidectomy for the original tumor, she consequentlyhad 3 courses of modified 5-fluorouracil, leucovorin,and oxaliplatin (mFOLFOX6) plus cetuximab. Computedtomography revealed a partial response, and theconfluence of the RHV and IVC got free from cancerinvasion. After 3 additional courses of mFOLFOX6 pluscetuximab, preoperative percutaneous transhepaticportal vein embolization (PTPE) was performed tosecure the future remnant liver volume. Finally, a righthemihepatectomy was performed. The postoperativecourse was uneventful. The patient was dischargedfrom the hospital on postoperative day 13. She hadneither local recurrence nor distant metastasis 18 moafter the last surgical intervention. This multidisciplinarystrategy, consisting of conversion chemotherapy usingFOLFOX plus cetuximab and PTPE, could contributein facilitating curative hepatic resection for initiallyunresectable CRLM.Key words: Initially unresectable; Colorectal liver metastasis;Conversion chemotherapy; Cetuximab; Percutaneoustranshepatic portal vein embolization

Improved Hypertrophy of Future Remnant Liver after Portal Vein Embolization with Plugs, Coils and Particles

2013 ◽  
Vol 37 (5) ◽  
pp. 1251-1258 ◽  
Author(s):  
Dominik Geisel ◽  
Maciej Malinowski ◽  
Maciej-Janusz Powerski ◽  
Joost Wüstefeld ◽  
Victoria Heller ◽  
...  
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Remnant Liver ◽  
Future Remnant Liver

scholarly journals Surgical Strategy for Future Remnant Liver Hypertrophy: Portal Vein Embolization vs. Liver Venous Deprivation

HPB ◽  
2021 ◽  
Vol 23 ◽  
pp. S46-S47
Author(s):  
M. Couto ◽  
F. Gianonne ◽  
B. Guiu ◽  
F. Navarro ◽  
F. Panaro
Keyword(s):  
Portal Vein ◽  
Portal Vein Embolization ◽  
Surgical Strategy ◽  
Remnant Liver ◽  
Future Remnant Liver

scholarly journals Assessment of Future Remnant Liver Function Using Hepatobiliary Scintigraphy in Patients Undergoing Major Liver Resection

2009 ◽  
Vol 14 (2) ◽  
pp. 369-378 ◽  
Author(s):  
Wilmar de Graaf ◽  
Krijn P. van Lienden ◽  
Sander Dinant ◽  
Joris J. T. H. Roelofs ◽  
Olivier R. C. Busch ◽  
...  
Keyword(s):  
Liver Resection ◽  
Liver Function ◽  
Hepatobiliary Scintigraphy ◽  
Remnant Liver ◽  
Future Remnant Liver ◽  
Major Liver Resection ◽  
Remnant Liver Function

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.

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