Radiological Simultaneous Portohepatic Vein Embolization (RASPE) Before Major Hepatectomy: A Better Way to Optimize Liver Hypertrophy Compared to Portal Vein Embolization.

Annals of Surgery
Christophe LaurentLaurence Chiche

Abstract

The aim of this retrospective study was to compare portal vein embolization (PVE) and radiologica simultaneous portohepatic vein embolization (RASPE) for future liver remnant (FLR) growth in terms of feasibility, safety, and efficacy. After portal vein embolization (PVE), 15% of patients remain ineligible for hepatic resection due to insufficient hypertrophy of the FLR. RASPE has been proposed to induce FLR growth. Between 2016 and 2018, 73 patients were included in the study. RASPE was proposed for patients with a ratio of FLR to total liver volume (FLR/TLV) of <25% (RASPE group). This group was compared to patients who underwent PVE for a FLR/TLV <30% (PVE group). Patients in the 2 groups were matched for age, sex, type of tumor, and number of chemotherapy treatments. FLR was assessed by computed tomography before and 4 weeks after the procedure. The technical success rate in both groups was 100%. Morbidity post-embolization, and the time between embolization and surgery were similar between the groups. In the PVE group, the FLR/TLV ratio before embolization was 31.03% (range: 18.33%-38.95%) versus 22.91% (range: 16.55-32.15) in the RASPE group (P < 0.0001). Four weeks after the procedure, the liver volume increased by 28.98%...Continue Reading

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Citations

Jul 19, 2020·Nature Reviews. Gastroenterology & Hepatology·Henrik PetrowskyPierre-Alain Clavien
Aug 26, 2020·Langenbeck's Archives of Surgery·Jan Heil, Erik Schadde
Jan 5, 2021·Annals of Surgical Oncology·Matthew E B Dixon, Niraj J Gusani
Jan 12, 2021·Zeitschrift für Gastroenterologie·Max MasthoffHaluk Morgul
May 4, 2021·Annals of Surgical Oncology·Eduardo A VegaClaudius Conrad
Jul 5, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Kenichiro ArakiKen Shirabe
Aug 29, 2021·HPB : the Official Journal of the International Hepato Pancreato Biliary Association·Mario GhosnJuan C Camacho

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