Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique
Purpose To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy. Materials and methods Seven patients (mean age:63.6y[42-77y]...
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| Veröffentlicht in: | European radiology 2016-12, Vol.26 (12), p.4259-4267 |
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| creator | Guiu, Boris Chevallier, Patrick Denys, Alban Delhom, Elisabeth Pierredon-Foulongne, Marie-Ange Rouanet, Philippe Fabre, Jean-Michel Quenet, François Herrero, Astrid Panaro, Fabrizio Baudin, Guillaume Ramos, Jeanne |
| description | Purpose
To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy.
Materials and methods
Seven patients (mean age:63.6y[42-77y]) underwent trans-hepatic LVD for liver metastases (n = 2), hepatocellular carcinoma (n = 1), intrahepatic cholangiocarcinoma (n = 3) and Klatskin tumour (n = 1). Assessment of future remnant liver (FRL) volume, liver enzymes and histology was performed.
Results
Technical success was 100 %. No complication occurred before surgery. Resection was performed in 6/7 patients. CT-scan revealed hepatic congestion in the venous-deprived area (6/7 patients). A mean of 3 days (range: 1–8 days) after LVD, transaminases increased (AST: from 42 ± 24U/L to 103 ± 118U/L, ALT: from 45 ± 25U/L to 163 ± 205U/L). Twenty-three days (range: 13–30 days) after LVD, FRL increased from 28.2 % (range: 22.4–33.3 %) to 40.9 % (range: 33.6–59.3 %). During the first 7 days, venous-deprived liver volume increased (+13.4 %) probably reflecting vascular congestion, whereas it strongly decreased (-21.3 %) at 3-4 weeks. Histology (embolized lobe) revealed sinusoidal dilatation, hepatocyte necrosis and important atrophy in all patients.
Conclusion
Trans-hepatic LVD technique is feasible, well tolerated and provides fast and important hypertrophy of the FRL. This new technique needs to be further evaluated and compared to portal vein embolization.
Key Points
•
Twenty-three days after LVD, FRL increased from 28.2 % (range:22.4-33.3 %) to 40.9 % (range:33.6–59.3 %)
•
During the first 7 days, venous-deprived liver volume increased (+13.4 %)
•
Venous-deprived liver volume strongly decreased (mean atrophy:229 cc; -21.3 %) at 3-4 weeks
•
Histology of venous
-
deprived liver revealed sinusoidal dilatation
,
hepatocyte necrosis and important atrophy |
| doi_str_mv | 10.1007/s00330-016-4291-9 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_hal_p</sourceid><recordid>TN_cdi_hal_primary_oai_HAL_hal_01871765v1</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>4243073941</sourcerecordid><originalsourceid>FETCH-LOGICAL-c505t-d9abbdd27ade34fc6d2b5b00b96219e0fa7c9ccb271f334e6b5fc7c9a9821c133</originalsourceid><addsrcrecordid>eNqNkUGL1TAUhYMozpvRH-BGCm6cRfXepE1e3A2DOsIDF-o6JOmtr4-2eSbtg3HlTzelM4MIgqvAyXdPzs1h7AXCGwRQbxOAEFACyrLiGkv9iG2wErxE2FaP2Qa02JZK6-qMnad0AACNlXrKzrgCDYh8w3596Ya5n-xIYU7FFO2Yyj0d7dT54hjiZPvCjk1xL52oGwsaXOi7n1kIY-GoDZGKwR5CXDHyUxhu3xXTnoq-O1HMU-Pi3tAxdqd1LFP7sfsx0zP2pLV9oud35wX79uH91-ubcvf546frq13pa6instHWuabhyjYkqtbLhrvaATgtOWqC1iqvvXdcYStERdLVrc-S1VuOHoW4YJer7972JucYbLw1wXbm5mpnFg1wq1DJ-oSZfb2yxxhyxDSZoUue-n79JoPbSlagtfoflEupciqd0Vd_oYcwxzEvnSmhUEqBKlO4Uj6GlCK1D2ERzNK6WVvPeaVZWjeL88s759kN1DxM3NecAb4CKV-N3yn-8fQ_XX8D0XG5XA</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1837166317</pqid></control><display><type>article</type><title>Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique</title><source>MEDLINE</source><source>Springer Nature - Complete Springer Journals</source><creator>Guiu, Boris ; Chevallier, Patrick ; Denys, Alban ; Delhom, Elisabeth ; Pierredon-Foulongne, Marie-Ange ; Rouanet, Philippe ; Fabre, Jean-Michel ; Quenet, François ; Herrero, Astrid ; Panaro, Fabrizio ; Baudin, Guillaume ; Ramos, Jeanne</creator><creatorcontrib>Guiu, Boris ; Chevallier, Patrick ; Denys, Alban ; Delhom, Elisabeth ; Pierredon-Foulongne, Marie-Ange ; Rouanet, Philippe ; Fabre, Jean-Michel ; Quenet, François ; Herrero, Astrid ; Panaro, Fabrizio ; Baudin, Guillaume ; Ramos, Jeanne</creatorcontrib><description>Purpose
To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy.
Materials and methods
Seven patients (mean age:63.6y[42-77y]) underwent trans-hepatic LVD for liver metastases (n = 2), hepatocellular carcinoma (n = 1), intrahepatic cholangiocarcinoma (n = 3) and Klatskin tumour (n = 1). Assessment of future remnant liver (FRL) volume, liver enzymes and histology was performed.
Results
Technical success was 100 %. No complication occurred before surgery. Resection was performed in 6/7 patients. CT-scan revealed hepatic congestion in the venous-deprived area (6/7 patients). A mean of 3 days (range: 1–8 days) after LVD, transaminases increased (AST: from 42 ± 24U/L to 103 ± 118U/L, ALT: from 45 ± 25U/L to 163 ± 205U/L). Twenty-three days (range: 13–30 days) after LVD, FRL increased from 28.2 % (range: 22.4–33.3 %) to 40.9 % (range: 33.6–59.3 %). During the first 7 days, venous-deprived liver volume increased (+13.4 %) probably reflecting vascular congestion, whereas it strongly decreased (-21.3 %) at 3-4 weeks. Histology (embolized lobe) revealed sinusoidal dilatation, hepatocyte necrosis and important atrophy in all patients.
Conclusion
Trans-hepatic LVD technique is feasible, well tolerated and provides fast and important hypertrophy of the FRL. This new technique needs to be further evaluated and compared to portal vein embolization.
Key Points
•
Twenty-three days after LVD, FRL increased from 28.2 % (range:22.4-33.3 %) to 40.9 % (range:33.6–59.3 %)
•
During the first 7 days, venous-deprived liver volume increased (+13.4 %)
•
Venous-deprived liver volume strongly decreased (mean atrophy:229 cc; -21.3 %) at 3-4 weeks
•
Histology of venous
-
deprived liver revealed sinusoidal dilatation
,
hepatocyte necrosis and important atrophy</description><identifier>ISSN: 0938-7994</identifier><identifier>EISSN: 1432-1084</identifier><identifier>DOI: 10.1007/s00330-016-4291-9</identifier><identifier>PMID: 27090112</identifier><language>eng</language><publisher>Berlin/Heidelberg: Springer Berlin Heidelberg</publisher><subject>Adult ; Aged ; Bile Duct Neoplasms - pathology ; Bile Duct Neoplasms - surgery ; Bioengineering ; Diagnostic Radiology ; Embolization ; Embolization, Therapeutic - methods ; Feasibility Studies ; Female ; Hepatectomy ; Hepatic Veins ; Histology ; Human health and pathology ; Humans ; Imaging ; Internal Medicine ; Interventional ; Interventional Radiology ; Life Sciences ; Liver ; Liver Function Tests ; Liver Neoplasms - pathology ; Liver Neoplasms - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Neuroradiology ; Nuclear medicine ; Portal Vein ; Preoperative Care - methods ; Radiology ; Surgeons ; Surgery ; Treatment Outcome ; Tumors ; Ultrasound ; Veins & arteries</subject><ispartof>European radiology, 2016-12, Vol.26 (12), p.4259-4267</ispartof><rights>European Society of Radiology 2016</rights><rights>Distributed under a Creative Commons Attribution 4.0 International License</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c505t-d9abbdd27ade34fc6d2b5b00b96219e0fa7c9ccb271f334e6b5fc7c9a9821c133</citedby><cites>FETCH-LOGICAL-c505t-d9abbdd27ade34fc6d2b5b00b96219e0fa7c9ccb271f334e6b5fc7c9a9821c133</cites><orcidid>0000-0003-1277-3054 ; 0000-0003-0415-3269 ; 0000-0002-9491-5097 ; 0000-0002-2275-7384</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s00330-016-4291-9$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s00330-016-4291-9$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>230,314,776,780,881,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/27090112$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://hal.science/hal-01871765$$DView record in HAL$$Hfree_for_read</backlink></links><search><creatorcontrib>Guiu, Boris</creatorcontrib><creatorcontrib>Chevallier, Patrick</creatorcontrib><creatorcontrib>Denys, Alban</creatorcontrib><creatorcontrib>Delhom, Elisabeth</creatorcontrib><creatorcontrib>Pierredon-Foulongne, Marie-Ange</creatorcontrib><creatorcontrib>Rouanet, Philippe</creatorcontrib><creatorcontrib>Fabre, Jean-Michel</creatorcontrib><creatorcontrib>Quenet, François</creatorcontrib><creatorcontrib>Herrero, Astrid</creatorcontrib><creatorcontrib>Panaro, Fabrizio</creatorcontrib><creatorcontrib>Baudin, Guillaume</creatorcontrib><creatorcontrib>Ramos, Jeanne</creatorcontrib><title>Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique</title><title>European radiology</title><addtitle>Eur Radiol</addtitle><addtitle>Eur Radiol</addtitle><description>Purpose
To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy.
Materials and methods
Seven patients (mean age:63.6y[42-77y]) underwent trans-hepatic LVD for liver metastases (n = 2), hepatocellular carcinoma (n = 1), intrahepatic cholangiocarcinoma (n = 3) and Klatskin tumour (n = 1). Assessment of future remnant liver (FRL) volume, liver enzymes and histology was performed.
Results
Technical success was 100 %. No complication occurred before surgery. Resection was performed in 6/7 patients. CT-scan revealed hepatic congestion in the venous-deprived area (6/7 patients). A mean of 3 days (range: 1–8 days) after LVD, transaminases increased (AST: from 42 ± 24U/L to 103 ± 118U/L, ALT: from 45 ± 25U/L to 163 ± 205U/L). Twenty-three days (range: 13–30 days) after LVD, FRL increased from 28.2 % (range: 22.4–33.3 %) to 40.9 % (range: 33.6–59.3 %). During the first 7 days, venous-deprived liver volume increased (+13.4 %) probably reflecting vascular congestion, whereas it strongly decreased (-21.3 %) at 3-4 weeks. Histology (embolized lobe) revealed sinusoidal dilatation, hepatocyte necrosis and important atrophy in all patients.
Conclusion
Trans-hepatic LVD technique is feasible, well tolerated and provides fast and important hypertrophy of the FRL. This new technique needs to be further evaluated and compared to portal vein embolization.
Key Points
•
Twenty-three days after LVD, FRL increased from 28.2 % (range:22.4-33.3 %) to 40.9 % (range:33.6–59.3 %)
•
During the first 7 days, venous-deprived liver volume increased (+13.4 %)
•
Venous-deprived liver volume strongly decreased (mean atrophy:229 cc; -21.3 %) at 3-4 weeks
•
Histology of venous
-
deprived liver revealed sinusoidal dilatation
,
hepatocyte necrosis and important atrophy</description><subject>Adult</subject><subject>Aged</subject><subject>Bile Duct Neoplasms - pathology</subject><subject>Bile Duct Neoplasms - surgery</subject><subject>Bioengineering</subject><subject>Diagnostic Radiology</subject><subject>Embolization</subject><subject>Embolization, Therapeutic - methods</subject><subject>Feasibility Studies</subject><subject>Female</subject><subject>Hepatectomy</subject><subject>Hepatic Veins</subject><subject>Histology</subject><subject>Human health and pathology</subject><subject>Humans</subject><subject>Imaging</subject><subject>Internal Medicine</subject><subject>Interventional</subject><subject>Interventional Radiology</subject><subject>Life Sciences</subject><subject>Liver</subject><subject>Liver Function Tests</subject><subject>Liver Neoplasms - pathology</subject><subject>Liver Neoplasms - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Neuroradiology</subject><subject>Nuclear medicine</subject><subject>Portal Vein</subject><subject>Preoperative Care - methods</subject><subject>Radiology</subject><subject>Surgeons</subject><subject>Surgery</subject><subject>Treatment Outcome</subject><subject>Tumors</subject><subject>Ultrasound</subject><subject>Veins & arteries</subject><issn>0938-7994</issn><issn>1432-1084</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2016</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqNkUGL1TAUhYMozpvRH-BGCm6cRfXepE1e3A2DOsIDF-o6JOmtr4-2eSbtg3HlTzelM4MIgqvAyXdPzs1h7AXCGwRQbxOAEFACyrLiGkv9iG2wErxE2FaP2Qa02JZK6-qMnad0AACNlXrKzrgCDYh8w3596Ya5n-xIYU7FFO2Yyj0d7dT54hjiZPvCjk1xL52oGwsaXOi7n1kIY-GoDZGKwR5CXDHyUxhu3xXTnoq-O1HMU-Pi3tAxdqd1LFP7sfsx0zP2pLV9oud35wX79uH91-ubcvf546frq13pa6instHWuabhyjYkqtbLhrvaATgtOWqC1iqvvXdcYStERdLVrc-S1VuOHoW4YJer7972JucYbLw1wXbm5mpnFg1wq1DJ-oSZfb2yxxhyxDSZoUue-n79JoPbSlagtfoflEupciqd0Vd_oYcwxzEvnSmhUEqBKlO4Uj6GlCK1D2ERzNK6WVvPeaVZWjeL88s759kN1DxM3NecAb4CKV-N3yn-8fQ_XX8D0XG5XA</recordid><startdate>20161201</startdate><enddate>20161201</enddate><creator>Guiu, Boris</creator><creator>Chevallier, Patrick</creator><creator>Denys, Alban</creator><creator>Delhom, Elisabeth</creator><creator>Pierredon-Foulongne, Marie-Ange</creator><creator>Rouanet, Philippe</creator><creator>Fabre, Jean-Michel</creator><creator>Quenet, François</creator><creator>Herrero, Astrid</creator><creator>Panaro, Fabrizio</creator><creator>Baudin, Guillaume</creator><creator>Ramos, Jeanne</creator><general>Springer Berlin Heidelberg</general><general>Springer Nature B.V</general><general>Springer Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QO</scope><scope>7RV</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8AO</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>KB0</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7P</scope><scope>NAPCQ</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>PRINS</scope><scope>7X8</scope><scope>1XC</scope><orcidid>https://orcid.org/0000-0003-1277-3054</orcidid><orcidid>https://orcid.org/0000-0003-0415-3269</orcidid><orcidid>https://orcid.org/0000-0002-9491-5097</orcidid><orcidid>https://orcid.org/0000-0002-2275-7384</orcidid></search><sort><creationdate>20161201</creationdate><title>Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique</title><author>Guiu, Boris ; Chevallier, Patrick ; Denys, Alban ; Delhom, Elisabeth ; Pierredon-Foulongne, Marie-Ange ; Rouanet, Philippe ; Fabre, Jean-Michel ; Quenet, François ; Herrero, Astrid ; Panaro, Fabrizio ; Baudin, Guillaume ; Ramos, Jeanne</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c505t-d9abbdd27ade34fc6d2b5b00b96219e0fa7c9ccb271f334e6b5fc7c9a9821c133</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2016</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Bile Duct Neoplasms - pathology</topic><topic>Bile Duct Neoplasms - surgery</topic><topic>Bioengineering</topic><topic>Diagnostic Radiology</topic><topic>Embolization</topic><topic>Embolization, Therapeutic - methods</topic><topic>Feasibility Studies</topic><topic>Female</topic><topic>Hepatectomy</topic><topic>Hepatic Veins</topic><topic>Histology</topic><topic>Human health and pathology</topic><topic>Humans</topic><topic>Imaging</topic><topic>Internal Medicine</topic><topic>Interventional</topic><topic>Interventional Radiology</topic><topic>Life Sciences</topic><topic>Liver</topic><topic>Liver Function Tests</topic><topic>Liver Neoplasms - pathology</topic><topic>Liver Neoplasms - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Neuroradiology</topic><topic>Nuclear medicine</topic><topic>Portal Vein</topic><topic>Preoperative Care - methods</topic><topic>Radiology</topic><topic>Surgeons</topic><topic>Surgery</topic><topic>Treatment Outcome</topic><topic>Tumors</topic><topic>Ultrasound</topic><topic>Veins & arteries</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Guiu, Boris</creatorcontrib><creatorcontrib>Chevallier, Patrick</creatorcontrib><creatorcontrib>Denys, Alban</creatorcontrib><creatorcontrib>Delhom, Elisabeth</creatorcontrib><creatorcontrib>Pierredon-Foulongne, Marie-Ange</creatorcontrib><creatorcontrib>Rouanet, Philippe</creatorcontrib><creatorcontrib>Fabre, Jean-Michel</creatorcontrib><creatorcontrib>Quenet, François</creatorcontrib><creatorcontrib>Herrero, Astrid</creatorcontrib><creatorcontrib>Panaro, Fabrizio</creatorcontrib><creatorcontrib>Baudin, Guillaume</creatorcontrib><creatorcontrib>Ramos, Jeanne</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Biotechnology Research Abstracts</collection><collection>Nursing & Allied Health Database</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Biological Science Database</collection><collection>Nursing & Allied Health Premium</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central China</collection><collection>MEDLINE - Academic</collection><collection>Hyper Article en Ligne (HAL)</collection><jtitle>European radiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Guiu, Boris</au><au>Chevallier, Patrick</au><au>Denys, Alban</au><au>Delhom, Elisabeth</au><au>Pierredon-Foulongne, Marie-Ange</au><au>Rouanet, Philippe</au><au>Fabre, Jean-Michel</au><au>Quenet, François</au><au>Herrero, Astrid</au><au>Panaro, Fabrizio</au><au>Baudin, Guillaume</au><au>Ramos, Jeanne</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique</atitle><jtitle>European radiology</jtitle><stitle>Eur Radiol</stitle><addtitle>Eur Radiol</addtitle><date>2016-12-01</date><risdate>2016</risdate><volume>26</volume><issue>12</issue><spage>4259</spage><epage>4267</epage><pages>4259-4267</pages><issn>0938-7994</issn><eissn>1432-1084</eissn><abstract>Purpose
To assess technical feasibility, safety, and efficacy of the liver venous deprivation (LVD) technique that combines both portal and hepatic vein embolization during the same procedure for liver preparation before major hepatectomy.
Materials and methods
Seven patients (mean age:63.6y[42-77y]) underwent trans-hepatic LVD for liver metastases (n = 2), hepatocellular carcinoma (n = 1), intrahepatic cholangiocarcinoma (n = 3) and Klatskin tumour (n = 1). Assessment of future remnant liver (FRL) volume, liver enzymes and histology was performed.
Results
Technical success was 100 %. No complication occurred before surgery. Resection was performed in 6/7 patients. CT-scan revealed hepatic congestion in the venous-deprived area (6/7 patients). A mean of 3 days (range: 1–8 days) after LVD, transaminases increased (AST: from 42 ± 24U/L to 103 ± 118U/L, ALT: from 45 ± 25U/L to 163 ± 205U/L). Twenty-three days (range: 13–30 days) after LVD, FRL increased from 28.2 % (range: 22.4–33.3 %) to 40.9 % (range: 33.6–59.3 %). During the first 7 days, venous-deprived liver volume increased (+13.4 %) probably reflecting vascular congestion, whereas it strongly decreased (-21.3 %) at 3-4 weeks. Histology (embolized lobe) revealed sinusoidal dilatation, hepatocyte necrosis and important atrophy in all patients.
Conclusion
Trans-hepatic LVD technique is feasible, well tolerated and provides fast and important hypertrophy of the FRL. This new technique needs to be further evaluated and compared to portal vein embolization.
Key Points
•
Twenty-three days after LVD, FRL increased from 28.2 % (range:22.4-33.3 %) to 40.9 % (range:33.6–59.3 %)
•
During the first 7 days, venous-deprived liver volume increased (+13.4 %)
•
Venous-deprived liver volume strongly decreased (mean atrophy:229 cc; -21.3 %) at 3-4 weeks
•
Histology of venous
-
deprived liver revealed sinusoidal dilatation
,
hepatocyte necrosis and important atrophy</abstract><cop>Berlin/Heidelberg</cop><pub>Springer Berlin Heidelberg</pub><pmid>27090112</pmid><doi>10.1007/s00330-016-4291-9</doi><tpages>9</tpages><orcidid>https://orcid.org/0000-0003-1277-3054</orcidid><orcidid>https://orcid.org/0000-0003-0415-3269</orcidid><orcidid>https://orcid.org/0000-0002-9491-5097</orcidid><orcidid>https://orcid.org/0000-0002-2275-7384</orcidid></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0938-7994 |
| ispartof | European radiology, 2016-12, Vol.26 (12), p.4259-4267 |
| issn | 0938-7994 1432-1084 |
| language | eng |
| recordid | cdi_hal_primary_oai_HAL_hal_01871765v1 |
| source | MEDLINE; Springer Nature - Complete Springer Journals |
| subjects | Adult Aged Bile Duct Neoplasms - pathology Bile Duct Neoplasms - surgery Bioengineering Diagnostic Radiology Embolization Embolization, Therapeutic - methods Feasibility Studies Female Hepatectomy Hepatic Veins Histology Human health and pathology Humans Imaging Internal Medicine Interventional Interventional Radiology Life Sciences Liver Liver Function Tests Liver Neoplasms - pathology Liver Neoplasms - surgery Male Medicine Medicine & Public Health Middle Aged Neuroradiology Nuclear medicine Portal Vein Preoperative Care - methods Radiology Surgeons Surgery Treatment Outcome Tumors Ultrasound Veins & arteries |
| title | Simultaneous trans-hepatic portal and hepatic vein embolization before major hepatectomy: the liver venous deprivation technique |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-14T20%3A49%3A34IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_hal_p&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Simultaneous%20trans-hepatic%20portal%20and%20hepatic%20vein%20embolization%20before%20major%20hepatectomy:%20the%20liver%20venous%20deprivation%20technique&rft.jtitle=European%20radiology&rft.au=Guiu,%20Boris&rft.date=2016-12-01&rft.volume=26&rft.issue=12&rft.spage=4259&rft.epage=4267&rft.pages=4259-4267&rft.issn=0938-7994&rft.eissn=1432-1084&rft_id=info:doi/10.1007/s00330-016-4291-9&rft_dat=%3Cproquest_hal_p%3E4243073941%3C/proquest_hal_p%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=1837166317&rft_id=info:pmid/27090112&rfr_iscdi=true |