Evaluation of clinical factors affecting the hypertrophy of the non-embolized lobe after the preoperative portal vein embolization (PTPE) in patients who underwent major hepatic resection with PTPE

In this study we examined liver function tests which could predict the degree of hypertrophy in the non-embolized lobe after the portal vein embolization (PTPE) in patients who underwent major hepatic resection after PTPE. In thirty-three patients who had undergone major hepatic resection after embolizing the right portal branch, the relationship between the values of the following clinical tests and the hypertrophic ratio of the left lobe were studied; the routine laboratory liver function test, blood cell counts, serum hyaluronate (HA), the indocyanine green retention rate 15 min after the injection of 0.5 mg/kg (ICGR15) and its K value, hepatic scintigraphy using Sn-colloid, the portal pressure measured before and immediately after PTPE during the procedure, and parenchymal volumetric rate of the right lobe (PVR). The hypertrophic ratio was calculated by using a computer tomography (CT) as the volume of the left lobe measured 2 weeks after PTPE/the volume of the left lobe before PTPE. As results, the hypertrophic ration had a negative correlation with the portal pressure measured before PTPE, that of after PTPE, ICGR15, HA, and a positive correlation with platelet counts, ChE, and PVR. Further a multiple regression analysis revealed that values of platelet counts, ChE, HA and PVR had a significance as a predictor of the hypertrophic ratio.