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01-05-2019 | Original Article

Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

Authors: Yoshihiro Inoue, Kensuke Fujii, Masatsugu Ishii, Syuji Kagota, Atsushi Tomioka, Hiroki Hamamoto, Wataru Osumi, Yusuke Tsuchimoto, Shinsuke Masubuchi, Masashi Yamamoto, Akira Asai, Koji Komeda, Tetsunosuke Shimizu, Mitsuhiro Asakuma, Shinya Fukunishi, Fumitoshi Hirokawa, Yoshihumi Narumi, Kazuhide Higuchi, Kazuhisa Uchiyama

Published in: Journal of Gastrointestinal Surgery | Issue 5/2019

Abstract

Background

Post-hepatectomy liver regeneration is of great interest to liver surgeons, and understanding the process of regeneration could contribute to increasing the safety of hepatectomies and improving prognoses.

Methods

Five hundred thirty-eight patients who underwent hepatectomy were retrospectively analyzed. Postoperative outcomes were evaluated, with a focus on the effects of portal vein resection and resected liver volume on remnant liver regeneration in patients with liver tumors. Remnant liver volumes (RLVs) and laboratory data were measured postoperatively using multidetector computed tomography on day 7 and months 1, 2, 5, 12, and 24 after the operation.

Results

Liver regeneration speed peaked at 1 week postoperatively and gradually decreased. Regeneration with large resections was longer than that with small resections, with the remnant liver regeneration rate being significantly lower in the former at all time points. Remnant liver regeneration plateaued around 5 months postoperatively, when regeneration is almost complete. Up to 1 month postoperatively, laboratory data were significantly worse when more portal veins was resected. After 2 months postoperatively, these data recovered to near normal levels.

Conclusion

The speed and rate of remnant liver regeneration primarily showed a strong correlation with the number of resected portal veins and the amount of removed liver parenchyma. The larger the resection ratio, the longer it took the liver to regenerate. We confirmed that recovery of the liver’s functional aspects accompanies recovery of the RLV.

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Title: Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy
Authors: Yoshihiro Inoue
Kensuke Fujii
Masatsugu Ishii
Syuji Kagota
Atsushi Tomioka
Hiroki Hamamoto
Wataru Osumi
Yusuke Tsuchimoto
Shinsuke Masubuchi
Masashi Yamamoto
Akira Asai
Koji Komeda
Tetsunosuke Shimizu
Mitsuhiro Asakuma
Shinya Fukunishi
Fumitoshi Hirokawa
Yoshihumi Narumi
Kazuhide Higuchi
Kazuhisa Uchiyama
Publication date: 01-05-2019
Publisher: Springer US
Published in: Journal of Gastrointestinal Surgery / Issue 5/2019
Print ISSN: 1091-255X
Electronic ISSN: 1873-4626
DOI: https://doi.org/10.1007/s11605-018-3985-5

At a glance: The STEP trials

Springer Medicine

Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

Abstract

Background

Methods

Results

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Background

Methods

Results

Conclusion

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