Parameters associated with changes in liver volume in patients undergoing portal vein embolization.
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.
Nanashima
Atsushi
A
Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
Sumida
Yorihisa
Y
Shibasaki
Shinichi
S
Takeshita
Hiroaki
H
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Shindou
Hisakazu
H
Abo
Takafumi
T
Yasutake
Toru
T
Nagayasu
Takeshi
T
Sakamoto
Ichiro
I
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
D015415:Biomarkers; D000469:Alkaline Phosphatase