Right portal vein ligation is as efficient as portal vein embolization to induce hypertrophy of the left liver remnant.
BACKGROUND
Aim of this retrospective study was to compare induction of left liver hypertrophy after right portal vein ligation (PVL) and right portal vein embolization (PVE) before right hepatectomy for liver metastases.


METHODS
Between 1998 and 2005, 18 patients underwent a PVE, whereas 17 patients underwent a PVL during a first stage laparotomy.


RESULTS
There was no complication related to PVE or PVL. After a similar interval time (7 +/- 3 vs 8 +/- 3 weeks), the increase of the left liver volume was similar between the two groups (35 +/- 38 vs 38 +/- 26%). After PVE and PVL, right hepatectomy was performed in 12 and 14 patients, respectively. Technical difficulties during the right hepatectomy were similar according to duration of procedure (6.4 +/- 1 vs 6.7 +/- 1 h, p = 0.7) and transfusion rates (33 vs 28%, p = 0.7). Mortality was nil in both groups, and morbidity rates were respectively 58% for the PVE group and 36% for the PVL group (p = 0.6).


CONCLUSIONS
Right PVL and PVE result in a comparable hypertrophy of the left liver. During the first laparotomy of a two-step liver resection, PVL can be efficiently and safely performed.
Aussilhou
B
B
Department of HPB Surgery, Beaujon Hospital (Assistance Publique-Hôpitaux de Paris), Bd Général Leclerc, Clichy, France.
Lesurtel
M
M
Sauvanet
A
A
Farges
O
O
Dokmak
S
S
Goasguen
N
N
Sibert
A
A
Vilgrain
V
V
Belghiti
J
J
D000368:Aged; D018278:Carcinoma, Neuroendocrine / Q000473:pathology; D015179:Colorectal Neoplasms / Q000473:pathology; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006529:Hepatomegaly; D006801:Humans; D006984:Hypertrophy; D008026:Ligation; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000601:surgery*; D011300:Preoperative Care; D012189:Retrospective Studies