Volumetric and functional recovery of the remnant liver after major liver resection with prior portal vein embolization : recovery after PVE and liver resection.
BACKGROUND
Portal vein embolization is an accepted method to increase the future remnant liver preoperatively. The aim of this study was to assess the effect of preoperative portal vein embolization on liver volume and function 3 months after major liver resection.


METHODS
This is a retrospective case-control study. Data were collected of patients who underwent portal vein embolization prior to (extended) right hemihepatectomy and of control patients who underwent the same type of resection without prior portal vein embolization. Liver volumes were measured by computed tomography volumetry before portal vein embolization, before liver resection, and 3 months after liver resection. Liver function was assessed by hepatobiliary scintigraphy before and 3 months after liver resection.


RESULTS
Ten patients were included in the embolization group and 13 in the control group. Groups were comparable for gender, age, and number of patients with a compromised liver. The mean future remnant liver volume was 33.0 +/- 8.0% prior to portal vein embolization in the embolization group and 45.6 +/- 9.1% in the control group (p < 0.01). Prior to surgery, there were no significant differences in future remnant liver volume and function between the groups. Three months postoperatively, the mean remnant liver volume was 81.9 +/- 8.9% of the initial total liver volume in the embolization group and 79.4 +/- 11.0% in the control group (p > 0.05). Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05).


CONCLUSIONS
Preoperative portal vein embolization does not negatively influence postoperative liver regeneration assessed 3 months after major liver resection.
van den Esschert
Jacomina W
JW
Department of Surgery, Academic Medical Center, IWO-1, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
de Graaf
Wilmar
W
van Lienden
Krijn P
KP
Busch
Olivier R
OR
Heger
Michal
M
van Delden
Otto M
OM
Gouma
Dirk J
DJ
Bennink
Roelof J
RJ
Laméris
Johan S
JS
van Gulik
Thomas M
TM
D000328:Adult; D000368:Aged; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000502:physiology*; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008115:Liver Regeneration / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D020127:Recovery of Function / Q000502:physiology*; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000379:methods*; D016896:Treatment Outcome