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Published in: CardioVascular and Interventional Radiology 7/2022

Open Access 21-03-2022 | Cholangiocarcinoma | Clinical Investigation

Liver Venous Deprivation (LVD) Versus Portal Vein Embolization (PVE) Alone Prior to Extended Hepatectomy: A Matched Pair Analysis

Authors: Georg Böning, Uli Fehrenbach, Timo Alexander Auer, Konrad Neumann, Martin Jonczyk, Johann Pratschke, Wenzel Schöning, Moritz Schmelzle, Bernhard Gebauer

Published in: CardioVascular and Interventional Radiology | Issue 7/2022

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Abstract

Background

To investigate whether liver venous deprivation (LVD) as simultaneous, portal vein (PVE) and right hepatic vein embolization offers advantages in terms of hypertrophy induction before extended hepatectomy in non-cirrhotic liver.

Materials and Methods

Between June 2018 and August 2019, 20 patients were recruited for a prospective, non-randomized study to investigate the efficacy of LVD. After screening of 134 patients treated using PVE alone from January 2015 to August 2019, 14 directly matched pairs regarding tumor entity (cholangiocarcinoma, CC and colorectal carcinoma, CRC) and hypertrophy time (defined as time from embolization to follow-up imaging) were identified. In both treatment groups, the same experienced reader (> 5 years experience) performed imaging-based measurement of the volumes of liver segments of the future liver remnant (FLR) prior to embolization and after the standard clinical hypertrophy interval (~ 30 days), before surgery. Percentage growth of segments was calculated and compared.

Results

After matched follow-up periods (mean of 30.5 days), there were no statistically significant differences in relative hypertrophy of FLRs. Mean ± standard deviation relative hypertrophy rates for LVD/PVE were 59 ± 29.6%/54.1 ± 27.6% (p = 0.637) for segments II + III and 48.2 ± 22.2%/44.9 ± 28.9% (p = 0.719) for segments II–IV, respectively.

Conclusions

LVD had no significant advantages over the standard method (PVE alone) in terms of hypertrophy induction of the FLR before extended hepatectomy in this study population.
Literature
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go back to reference Hocquelet A, Sotiriadis C, Duran R, Guiu B, Yamaguchi T, Halkic N, et al. Preoperative portal vein embolization alone with biliary drainage compared to a combination of simultaneous portal vein, right hepatic vein embolization and biliary drainage in klatskin tumor. Cardiovasc Intervent Radiol. 2018;41(12):1885–91. https://doi.org/10.1007/s00270-018-2075-0.CrossRefPubMed Hocquelet A, Sotiriadis C, Duran R, Guiu B, Yamaguchi T, Halkic N, et al. Preoperative portal vein embolization alone with biliary drainage compared to a combination of simultaneous portal vein, right hepatic vein embolization and biliary drainage in klatskin tumor. Cardiovasc Intervent Radiol. 2018;41(12):1885–91. https://​doi.​org/​10.​1007/​s00270-018-2075-0.CrossRefPubMed
Metadata
Title
Liver Venous Deprivation (LVD) Versus Portal Vein Embolization (PVE) Alone Prior to Extended Hepatectomy: A Matched Pair Analysis
Authors
Georg Böning
Uli Fehrenbach
Timo Alexander Auer
Konrad Neumann
Martin Jonczyk
Johann Pratschke
Wenzel Schöning
Moritz Schmelzle
Bernhard Gebauer
Publication date
21-03-2022
Publisher
Springer US
Published in
CardioVascular and Interventional Radiology / Issue 7/2022
Print ISSN: 0174-1551
Electronic ISSN: 1432-086X
DOI
https://doi.org/10.1007/s00270-022-03107-0

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