Combined biembolization induces higher hypertrophy than portal vein embolization before major liver resection

Roy, Bertrand Le; Gallon, A.; Cauchy, François; Pereira, Bruno; Gagnière, Johan; Lambert, Céline; Yoh, Tomoaki; Boyer, L.; Pezet, Denis; Buc, Emmanuel; Chabrot, P.

doi:10.1016/j.hpb.2019.08.005

Cited by 48 publications

(55 citation statements)

References 36 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“… Kobayashi et al [ 29 ] 2020 Comparative study PVE/HVE: 21 * PVE: 39 CRLM: 10 HCC: 2 PHCC: 8 Transjugular AVP RHV: 18 RHV+MHV: 2 Hemobilia: 1 n.r. Le Roy et al [ 30 ] 2020 Comparative study PVE/HVE: 31 PVE: 41 CRLM: 18 HCC: 5 IHCC: 2 PHCC: 5 Other: 1 Transjugular AVP RHV: 27 RHV+MHV: 3 MHV: 1 0 1 day Laurent et al [ 31 ] 2020 Comparative study PVE/HVE: 37 + PVE:36 CRLM:23 IHCC: 7 HCC: 4 NET: 2 Transjugular AVP + NBCA/lipiodol RHV: 29 RHV+MHV: 8 Dindo-Clavien: I: 34 II: 3 1.4 days (1–5) n.r not reported, AVP Amplatzer Vascular Plug, CRLM colorectal liver metastasis, HCC hepatocellular carcinoma, IHCC intrahepatic cholangiocarcinoma, MHV middle hepatic vein, NBCA/lipiodol N-butyl-cyanoacrylate and iodized oil, NE : neuroendocrine tumor, PHCC perihilar cholangiocarcinoma, PVE portal vein embolization, PVE/HVE simultaneous portal and hepatic vein embolization, RHV right hepatic vein * Tumor type and information about the embolization were not given in one patient who failed to achieve liver resection + Tumor type of one patient was not given …”

Section: Simultaneous Portal and Hepatic Vein Embolizationmentioning

confidence: 99%

“…Impressively, the Montpellier LVD technique is already being tested in an ongoing randomized controlled trail (RCT) of 8 centers in France (NCT03995459). However, the majority of published articles, which are not from the Montpellier group, except one article from Bordeaux, [ 31 ] did not use the additive liquid embolization of hepatic veins following AVP occlusion, but only placed AVPs without much attention to the small veins flowing to the AVPs (Table 1 ) [ 26 , 27 , 29 , 30 ]. Also, the Montpellier group used a transhepatic approach for the hepatic vein embolization [ 15 , 25 , 28 ], which has also been adopted by the Bordeaux group [ 31 ].…”

Section: Simultaneous Portal and Hepatic Vein Embolizationmentioning

confidence: 99%

“…Also, the Montpellier group used a transhepatic approach for the hepatic vein embolization [ 15 , 25 , 28 ], which has also been adopted by the Bordeaux group [ 31 ]. All other groups use the more common transjugular approach as their standard method [ 26 , 27 , 29 , 30 ].…”

Section: Simultaneous Portal and Hepatic Vein Embolizationmentioning

confidence: 99%

See 2 more Smart Citations

Simultaneous portal and hepatic vein embolization before major liver resection

Heil

Schadde

2020

Langenbecks Arch Surg

View full text Add to dashboard Cite

Background Regenerative liver surgery expands the limitations of technical resectability by increasing the future liver remnant (FLR) volume before extended resections in order to avoid posthepatectomy liver failure (PHLF). Portal vein rerouting with ligation of one branch of the portal vein bifurcation (PVL) or embolization (PVE) leads to a moderate liver volume increase over several weeks with a clinical dropout rate of 20–40%, mostly due to tumor progression during the waiting period. Accelerated liver regeneration by the Associating Liver Partition and Portal vein Ligation for Staged hepatectomy (ALPPS) was poised to overcome this limitation by reduction of the waiting time, but failed due increased perioperative complications. Simultaneous portal and hepatic vein embolization (PVE/HVE) is a novel minimal invasive way to induce rapid liver growth without the need of two surgeries. Purpose This article summarizes published results of PVE/HVE and analyzes what is known about its efficacy to achieve resection, safety, and the volume changes induced. Conclusions PVE/HVE holds promise to induce accelerated liver regeneration in a similar safety profile to PVE. The demonstrated accelerated hypertrophy may increase resectability. Randomized trials will have to compare PVE/HVE and PVE to determine if PVE/HVE is superior to PVE.

show abstract

Section: Simultaneous Portal and Hepatic Vein Embolizationmentioning

confidence: 99%

Section: Simultaneous Portal and Hepatic Vein Embolizationmentioning

confidence: 99%

See 1 more Smart Citation

Simultaneous portal and hepatic vein embolization before major liver resection

Heil

Schadde

2020

Langenbecks Arch Surg

View full text Add to dashboard Cite

show abstract

“…Since the first publication, seven further reports including between 6 and 37 patients have been published [17,18,[23][24][25][26][27][28]. PVE/HVE was mainly used to treat CRLM (55%); however, most studies included both primary and secondary liver tumors [29].…”

Section: One-stage Hepatectomy With Portal Veinand Hepatic Vein Embolmentioning

confidence: 99%

Induction of liver hypertrophy for extended liver surgery and partial liver transplantation: State of the art of parenchyma augmentation–assisted liver surgery

Müller¹,

Linecker

Kırımker

et al. 2021

Langenbecks Arch Surg

View full text Add to dashboard Cite

Background Liver surgery and transplantation currently represent the only curative treatment options for primary and secondary hepatic malignancies. Despite the ability of the liver to regenerate after tissue loss, 25–30% future liver remnant is considered the minimum requirement to prevent serious risk for post-hepatectomy liver failure. Purpose The aim of this review is to depict the various interventions for liver parenchyma augmentation–assisting surgery enabling extended liver resections. The article summarizes one- and two-stage procedures with a focus on hypertrophy- and corresponding resection rates. Conclusions To induce liver parenchymal augmentation prior to hepatectomy, most techniques rely on portal vein occlusion, but more recently inclusion of parenchymal splitting, hepatic vein occlusion, and partial liver transplantation has extended the technical armamentarium. Safely accomplishing major and ultimately total hepatectomy by these techniques requires integration into a meaningful oncological concept. The advent of highly effective chemotherapeutic regimen in the neo-adjuvant, interstage, and adjuvant setting has underlined an aggressive surgical approach in the given setting to convert formerly “palliative” disease into a curative and sometimes in a “chronic” disease.

show abstract

“…cirrhosis) as well as after iatrogenic liver ischemia with rapid deterioration of liver function. Moreover, liver volumetry has been increasingly performed preceding intra-arterial or portal-venous interventions [ 3 – 6 ]. Due to its complex, variable shape, and proximity to other anatomical structures, liver segmentation, and quantification is challenging.…”

Section: Introductionmentioning

confidence: 99%

Fully automated whole-liver volume quantification on CT-image data: Comparison with manual volumetry using enhanced and unenhanced images as well as two different radiation dose levels and two reconstruction kernels

et al. 2021

View full text Add to dashboard Cite

Objectives To evaluate the accuracy of fully automated liver volume quantification vs. manual quantification using unenhanced as well as enhanced CT-image data as well as two different radiation dose levels and also two image reconstruction kernels. Material and methods The local ethics board gave its approval for retrospective data analysis. Automated liver volume quantification in 300 consecutive livers in 164 male and 103 female oncologic patients (64±12y) performed at our institution (between January 2020 and May 2020) using two different dual-energy helicals: portal-venous phase enhanced, ref. tube current 300mAs (CARE Dose4D) for tube A (100 kV) and ref. 232mAs tube current for tube B (Sn140kV), slice collimation 0.6mm, reconstruction kernel I30f/1, recon. thickness of 0.6mm and 5mm, 80–100 mL iodine contrast agent 350 mg/mL, (flow 2mL/s) and unenhanced ref. tube current 100mAs (CARE Dose4D) for tube A (100 kV) and ref. 77mAs tube current for tube B (Sn140kV), slice collimation 0.6mm (kernel Q40f) were analyzed. The post-processing tool (syngo.CT Liver Analysis) is already FDA-approved. Two resident radiologists with no and 1-year CT-experience performed both the automated measurements independently from each other. Results were compared with those of manual liver volume quantification using the same software which was supervised by a senior radiologist with 30-year CT-experience (ground truth). Results In total, a correlation of 98% was obtained for liver volumetry based on enhanced and unenhanced data sets compared to the manual liver quantification. Radiologist #1 and #2 achieved an inter-reader agreement of 99.8% for manual liver segmentation (p<0.0001). Automated liver volumetry resulted in an overestimation (>5% deviation) of 3.7% for unenhanced CT-image data and 4.0% for contrast-enhanced CT-images. Underestimation (<5%) of liver volume was 2.0% for unenhanced CT-image data and 1.3% for enhanced images after automated liver volumetry. Number and distribution of erroneous volume measurements using either thin or thick slice reconstructions was exactly the same, both for the enhanced as well for the unenhanced image data sets (p> 0.05). Conclusion Results of fully automated liver volume quantification are accurate and comparable with those of manual liver volume quantification and the technique seems to be confident even if unenhanced lower-dose CT image data is used.

show abstract

Combined biembolization induces higher hypertrophy than portal vein embolization before major liver resection

Cited by 48 publications

References 36 publications

Simultaneous portal and hepatic vein embolization before major liver resection

Simultaneous portal and hepatic vein embolization before major liver resection

Induction of liver hypertrophy for extended liver surgery and partial liver transplantation: State of the art of parenchyma augmentation–assisted liver surgery

Fully automated whole-liver volume quantification on CT-image data: Comparison with manual volumetry using enhanced and unenhanced images as well as two different radiation dose levels and two reconstruction kernels

Contact Info

Product

Resources

About