Liver venous deprivation versus portal vein embolization before major hepatectomy:future liver remnant volumetric and functional changes

作     者：Boris Guiu François Quenet Fabrizio Panaro Lauranne Piron Christophe Cassinotto Astrid Herrerro François-Régis Souche Margaux Hermida Marie-Ange Pierredon-Foulongne Ali Belgour Serge Aho-Glele Emmanuel Deshayes 

作者机构：Department of RadiologySt-Eloi University HospitalMontpellierFrance Department of SurgeryInstitut du Cancer de Montpellier(ICM)MontpellierFrance Department of SurgerySt-Eloi University HospitalMontpellierFrance Department of EpidemiologyDijon University HospitalDijonFrance Department of Nuclear MedicineInstitut de Recherche en Cancérologie de Montpellier(IRCM)INSERM U1194MontpellierFrance 

出 版 物：《Hepatobiliary Surgery and Nutrition》 (肝胆外科与营养（英文）)

年 卷 期：2020年第9卷第5期

页      面：564-576页

核心收录：

学科分类：1002[医学-临床医学] 100214[医学-肿瘤学] 10[医学] 

主　　题：Portal vein embolization(PVE) liver venous deprivation(LVD) resection hepatectomy mebrofenin 

摘      要：Background:We previously showed that embolization of portal inflow and hepatic vein(HV)outflow(liver venous deprivation,LVD)promotes future liver remnant(FLR)volume(FLR-V)and function(FLR-F)***,we compared FLR-V and FLR-F changes after portal vein embolization(PVE)and ***:This study included all patients referred for liver preparation before major hepatectomy over 26 *** criteria were:unavailable baseline/follow-up imaging,cirrhosis,Klatskin tumor,two-stage hepatectomy.99mTc-mebrofenin SPECT-CT was performed at baseline and at day 7,14 and 21 after PVE or ***-V and FLR-F variations were compared using multivariate generalized linear mixed models(joint modelling)with/without missing data ***:Baseline FLR-F was lower in the LVD(n=29)than PVE group(n=22)(P0.001).Technical success was 100%in both groups without any major *** in FLR-V at day 14 and 21(+14.2%vs.+50%,P=0.002;and+18.6%vs.+52.6%,P=0.001),and in FLR-F at day 7,14 and 21(+23.1%vs.+54.3%,P=0.02;+17.6%vs.+56.1%,P=0.006;and+29.8%vs.+63.9%,P0.001)differed between PVE and LVD ***(P=0.009),age(P=0.027)and baseline FLR-V(P=0.001)independently predicted FLR-V variations,whereas only LVD(P=0.01)predicted FLR-F *** missing data handling,LVD remained an independent predictor of FLR-V and FLR-F ***:LVD is safe and provides greater FLR-V and FLR-F increase than *** results are now evaluated in the HYPERLIV-01 multicenter randomized trial.