title: Impaired liver function attenuates liver regeneration and hypertrophy after portal vein embolization.
abstract: OBJECTIVE
  To clarify the clinical factors associated with liver regeneration after major hepatectomy and the hypertrophic rate after portal vein embolization (PVE).
  
  
  METHODS
  A total of 63 patients who underwent major hepatectomy and 13 patients who underwent PVE in a tertiary care hospital between January 2012 and August 2015 were included in the analysis. We calculated the remnant liver volume following hepatectomy using contrast-enhanced computed tomography (CT) performed before and approximately 3-6 mo after hepatectomy. Furthermore, we calculated the liver volume using CT performed 2-4 wk after PVE. Preoperative patient characteristics and laboratory data were analyzed to identify factors affecting postoperative liver regeneration or hypertrophy rate following PVE.
  
  
  RESULTS
  The remnant liver volume/total liver volume ratio negatively correlated with the liver regeneration rate after hepatectomy (ρ= -0.850,P< 0.001). The regeneration rate was significantly lower in patients with an indocyanine green retention rate at 15 min (ICG-R15) of ≥ 20% in the right hepatectomy group but not in the left hepatectomy group. The hypertrophic rate after PVE positively correlated with the regeneration rate after hepatectomy (ρ= 0.648,P= 0.017). In addition, the hypertrophic rate after PVE was significantly lower in patients with an ICG-R15 ≥ 20% and a serum total bilirubin ≥ 1.5 mg/dL.
  
  
  CONCLUSIONS
  The regeneration rate after major hepatectomy correlated with hypertrophic rate after PVE. Both of them were attenuated in the presence of impaired liver function.
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Yumiko
authors.initials: Y
authors.lastname: Kageyama
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Kokudo
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Katsumi
authors.initials: K
authors.lastname: Amikura
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Miyazaki
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Amane
authors.initials: A
authors.lastname: Takahashi
authors.affiliation: Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan.
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Sakamoto
keywords: Clinical factors; Hypertrophy; Major hepatectomy; Portal vein embolization; Regeneration after hepatectomy