title: Parameters associated with changes in liver volume in patients undergoing portal vein embolization.
abstract: BACKGROUND
  To identify predictors of changes in hepatic volumes after portal vein embolization (PVE) before hepatectomy, we examined the relationship between clinicopathological parameters and changes in volume of embolized and nonembolized liver and regeneration of remnant liver after hepatectomy.
  
  
  METHODS
  The subjects were 25 patients who underwent laparotomy. PVE was performed through transileocolic vein (n = 15) and percutaneous transhepatic puncture (n = 10).
  
  
  RESULTS
  Significant atrophy and hypertrophy of the embolized and nonembolized liver were observed after PVE, respectively, and further increase of remnant liver volume was observed after hepatectomy. Background liver disease did not seem to influence the results. Alkaline phosphatase (ALP) level correlated negatively with atrophy of embolized lobe (r = -0.433). Platelet count correlated positively with hypertrophy of nonembolized lobe (r = 0.412, P < 0.05) and percent increase between lobes and (r = 0.515, P < 0.05). Seven (32%) patients developed postoperative complications, such as long-term ascites or cholestasis. Changes in embolized liver and percent increase between lobes in patients with postoperative cholestasis (-94 +/- 97 cm(3) and 9.6 +/- 5.1% gain) were significantly lower than those in patients without cholestasis (17 +/- 54 cm(3) and 6.6 +/- 1.3% gain, P < 0.05).
  
  
  CONCLUSIONS
  ALP and platelet counts might be able to predict PVE effect and were related to postoperative course. Identification of more specific predictors is desirable.
authors.affiliation: Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nanashima
authors.forename: Yorihisa
authors.initials: Y
authors.lastname: Sumida
authors.forename: Shinichi
authors.initials: S
authors.lastname: Shibasaki
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Takeshita
authors.forename: Shigekazu
authors.initials: S
authors.lastname: Hidaka
authors.forename: Terumitsu
authors.initials: T
authors.lastname: Sawai
authors.forename: Hisakazu
authors.initials: H
authors.lastname: Shindou
authors.forename: Takafumi
authors.initials: T
authors.lastname: Abo
authors.forename: Toru
authors.initials: T
authors.lastname: Yasutake
authors.forename: Takeshi
authors.initials: T
authors.lastname: Nagayasu
authors.forename: Ichiro
authors.initials: I
authors.lastname: Sakamoto
mesh_terms: D000328:Adult; D000368:Aged; D000469:Alkaline Phosphatase / Q000097:blood; D001284:Atrophy; D015415:Biomarkers; D003131:Combined Modality Therapy; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D006984:Hypertrophy; D008099:Liver / Q000473:pathology* / Q000601:surgery; D008107:Liver Diseases / Q000473:pathology* / Q000601:surgery*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D010976:Platelet Count; D011169:Portal Vein; D011183:Postoperative Complications / Q000473:pathology / Q000517:prevention & control; D011237:Predictive Value of Tests; D011300:Preoperative Care
chemical_list: D015415:Biomarkers; D000469:Alkaline Phosphatase