title: Percentage of future liver remnant volume before portal vein embolization influences the degree of liver regeneration after hepatectomy.
abstract: BACKGROUND
  Clinical determinants of liver regeneration induced by portal vein embolization (PVE) and hepatectomy remain unclear. The aims of this study were to investigate how liver regeneration occurs after PVE followed by hepatectomy and to determine which factors strongly promote liver regeneration.
  
  
  METHODS
  Thirty-six patients who underwent both preoperative PVE and major hepatectomy were enrolled in this study. Percentage of future liver remnant volume before PVE (%FLR-pre) was compared with the remnant liver volume after PVE (%FLR-post-PVE) and on postoperative day 7 after hepatic resection (%FLR-post-HR). Clinical indicators contributing to liver regeneration induced by both PVE and hepatectomy were examined by logistic regression analysis.
  
  
  RESULTS
  PVE and hepatectomy caused a two-step regeneration. FLR-pre, FLR-post-PVE, and FLR-post-HR were 448, 579, and 761 cm(3), respectively. The %FLR-pre was significantly associated with liver regeneration induced by both PVE and hepatectomy (r = 0.63, p < 0.0001). Multiple regression analysis showed that only %FLR-pre was independently correlated with posthepatectomy liver regeneration (p = 0.027, odds ratio = 13.8).
  
  
  CONCLUSIONS
  After PVE and the subsequent hepatectomy, liver regeneration was accomplished in a two-step manner. Liver regeneration was strongly influenced by the %FLR-pre.
authors.affiliation: Department of Gastroenterological Surgery, Graduate School of Life Sciences, Kumamoto University, 1-1-1 Honjo, Kumamoto City, Kumamoto, 860-8556, Japan.
authors.forename: Hirohisa
authors.initials: H
authors.lastname: Okabe
authors.forename: Toru
authors.initials: T
authors.lastname: Beppu
authors.forename: Shigeki
authors.initials: S
authors.lastname: Nakagawa
authors.forename: Morikatsu
authors.initials: M
authors.lastname: Yoshida
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Hayashi
authors.forename: Toshiro
authors.initials: T
authors.lastname: Masuda
authors.forename: Katsunori
authors.initials: K
authors.lastname: Imai
authors.forename: Kosuke
authors.initials: K
authors.lastname: Mima
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Kuroki
authors.forename: Hidetoshi
authors.initials: H
authors.lastname: Nitta
authors.forename: Daisuke
authors.initials: D
authors.lastname: Hashimoto
authors.forename: Akira
authors.initials: A
authors.lastname: Chikamoto
authors.forename: Takatoshi
authors.initials: T
authors.lastname: Ishiko
authors.forename: Masayuki
authors.initials: M
authors.lastname: Watanabe
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Yamashita
authors.forename: Hideo
authors.initials: H
authors.lastname: Baba
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008099:Liver / Q000033:anatomy & histology* / Q000000981:diagnostic imaging; D008107:Liver Diseases / Q000601:surgery*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein; D011859:Radiography