Preoperative portal vein embolization for extension of hepatectomy indications

Hepatology : Official Journal of the American Association for the Study of Liver Diseases
T de BaereV Bousson

Abstract

To render hepatectomy feasible in patients with an initially deficient volume of the future remnant liver (FRL), we redistributed portal blood flow rich in hepatotrophic substances toward the FRL. Redistribution was achieved with preoperative portal vein embolization (POPE) feeding the future resected liver. POPE was performed in 31 patients, under fluoroscopic guidance, via a percutaneous access. POPE was well tolerated and surgery was practicable in 24 patients without severe postoperative liver failure. Seven operations were cancelled, but only one due to insufficient hypertrophy of the FRL. FRL volume values were 90 to 560 mL (mean 260 mL) before POPE and 160-783 mL (mean 443 mL) after POPE, which represents a median increase of 79% +/- 50%. Hypertrophy of the FRL was 90% +/- 52% after 30 days with cyanoacrylate, 53% +/- 6% after 43 days with Gelfoam, and 44% +/- 30% after 35 days with coils. Slight shrinkage was obtained in the volume of the embolized liver, for which resection was planned. Overall survival was 2-62 months (mean 26 months), disease-free survival was 0-60 months (mean 19 months), and 7 patients are disease-free and alive 14 to 60 months (mean 43 months) after surgery. Although exclusively applicable in a li...Continue Reading

Citations

Feb 5, 2010·Cardiovascular and Interventional Radiology·Alban DenysUNKNOWN Cardiovascular and Interventional Radiological Society of Europe
Jul 19, 2012·Cardiovascular and Interventional Radiology·K P van LiendenO M van Delden
Mar 2, 2005·Journal of the American College of Surgeons·Neal R BarshesJohn A Goss
Mar 25, 2014·Journal of Vascular and Interventional Radiology : JVIR·Aaron M FischmanRobert A Lookstein
Jun 3, 2000·The Surgical Clinics of North America·J I TsaoR A Oberfield
May 22, 2002·Surgical Oncology·Ming-Hui Fan, Alfred E Chang
May 31, 2001·Journal of Viral Hepatitis·R TeixeiraA K Burroughs
Sep 1, 2008·Seminars in Interventional Radiology·Eric M Walser
Mar 1, 2004·Seminars in Interventional Radiology·William S Rilling, Gene W Chen
Jun 1, 2008·Seminars in Interventional Radiology·Rony AvritscherDavid C Madoff
Feb 1, 2003·Annals of Surgery·Olivier FargesAlain Sauvanet
Oct 20, 2004·Annals of Surgery·Thomas ZachariasJean-Christophe Weber
Jun 17, 1999·Alcoholism, Clinical and Experimental Research·R A Rippe
Aug 15, 2013·World Journal of Surgical Oncology·Eloisa FranchiMarcello Maestri
May 13, 2008·World Journal of Surgical Oncology·Pejman RadkaniThomas W Mesko
Jun 21, 2008·World Journal of Gastroenterology : WJG·Spiros-G Delis, Christos Dervenis
Jul 24, 2010·World Journal of Gastroenterology : WJG·Dimitrios DimitroulisGregory Kouraklis
Jun 24, 2006·AJR. American Journal of Roentgenology·Alban L DenysFrancesco Doenz
Nov 25, 2000·AJR. American Journal of Roentgenology·T de BaereA Roche
Mar 12, 2008·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·K SeymourD Manas
Dec 25, 2009·The Journal of Surgical Research·Jeng-Hwei TsengTa-Sen Yeh
Apr 2, 1999·Journal of Vascular and Interventional Radiology : JVIR·S ParkH Y Song
May 20, 2008·Surgical Oncology Clinics of North America·Daniel Jaeck, Patrick Pessaux
Nov 6, 2007·Techniques in Vascular and Interventional Radiology·Thierry de BaereDavid C Madoff
Sep 9, 2015·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Raphael P H MeierPietro E Majno
Oct 20, 2012·HPB Surgery : a World Journal of Hepatic, Pancreatic and Biliary Surgery·Irinel Popescu, Sorin Tiberiu Alexandrescu
Apr 4, 2006·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·C Y Hao, J F Ji
Jan 26, 2006·European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology·P LindnérM Rizell
Sep 7, 2013·Diagnostic and Interventional Imaging·J CazejustY Menu
Mar 17, 2004·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Pierre-Alain ClavienSteven M Strasberg

❮ Previous
Next ❯

Related Concepts

Trending Feeds

COVID-19

Coronaviruses encompass a large family of viruses that cause the common cold as well as more serious diseases, such as the ongoing outbreak of coronavirus disease 2019 (COVID-19; formally known as 2019-nCoV). Coronaviruses can spread from animals to humans; symptoms include fever, cough, shortness of breath, and breathing difficulties; in more severe cases, infection can lead to death. This feed covers recent research on COVID-19.

Blastomycosis

Blastomycosis fungal infections spread through inhaling Blastomyces dermatitidis spores. Discover the latest research on blastomycosis fungal infections here.

Nuclear Pore Complex in ALS/FTD

Alterations in nucleocytoplasmic transport, controlled by the nuclear pore complex, may be involved in the pathomechanism underlying multiple neurodegenerative diseases including Amyotrophic Lateral Sclerosis and Frontotemporal Dementia. Here is the latest research on the nuclear pore complex in ALS and FTD.

Applications of Molecular Barcoding

The concept of molecular barcoding is that each original DNA or RNA molecule is attached to a unique sequence barcode. Sequence reads having different barcodes represent different original molecules, while sequence reads having the same barcode are results of PCR duplication from one original molecule. Discover the latest research on molecular barcoding here.

Chronic Fatigue Syndrome

Chronic fatigue syndrome is a disease characterized by unexplained disabling fatigue; the pathology of which is incompletely understood. Discover the latest research on chronic fatigue syndrome here.

Evolution of Pluripotency

Pluripotency refers to the ability of a cell to develop into three primary germ cell layers of the embryo. This feed focuses on the mechanisms that underlie the evolution of pluripotency. Here is the latest research.

Position Effect Variegation

Position Effect Variagation occurs when a gene is inactivated due to its positioning near heterochromatic regions within a chromosome. Discover the latest research on Position Effect Variagation here.

STING Receptor Agonists

Stimulator of IFN genes (STING) are a group of transmembrane proteins that are involved in the induction of type I interferon that is important in the innate immune response. The stimulation of STING has been an active area of research in the treatment of cancer and infectious diseases. Here is the latest research on STING receptor agonists.

Microbicide

Microbicides are products that can be applied to vaginal or rectal mucosal surfaces with the goal of preventing, or at least significantly reducing, the transmission of sexually transmitted infections. Here is the latest research on microbicides.