Does Preoperative Portal Vein Embolization Have Any Impact on the Outcome of Right-Side Hepatectomy for Klatskin Tumor?

作者：Kang Mee Joo; Jang Jin Young; Kwon Wooil; Park Jae Woo; Chang Ye Rim; Kim Sun Whe^*

来源：Journal of Gastrointestinal Surgery, 2013, 17(9): 1592-1599.

DOI：10.1007/s11605-013-2247-9

• Hepatectomy
• Klatskin tumor
• Portal vein
• Embolization
• Liver failure

The clinical usefulness of portal vein embolization (PVE) for Klatskin tumor is not well established. The authors explored the change in liver volume and function before and after major hepatectomy and evaluated the effect of PVE.
Thirty-three consecutive patients who underwent right hepatectomy with an initial future liver remnant (FLR) a parts per thousand currency signaEuro parts per thousand 30 % for Klatskin tumors at Seoul National University Hospital were included.
Eleven patients underwent PVE, and eight patients received right trisectionectomy. PVE induced a mean FLR increase of 19.3 % after a mean of 15.8 days. At postoperative month 1, liver volume and liver hypertrophy ratio was comparable between PVE and no-PVE group. For patients with an initial FLR a parts per thousand currency signaEuro parts per thousand 20 %, postoperative liver hypertrophy rate of PVE group was comparable to no-PVE group. Liver function tests were not affected by PVE or the initial FLR. Postoperative liver hypertrophy ratio was negatively correlated with the initial FLR (hypertrophy ratio (%) = 326.7-0.4xinitial FLR (ml), P = 0.001). There was no severe PVE-related morbidity, and postoperative morbidity rate was comparable in PVE and no-PVE group.
The postoperative liver hypertrophy ratio, final liver volume, or liver function tests were not affected by PVE. Postoperative liver hypertrophy was related to the initial FLR.

• 出版日期2013-9