Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach.

Nagino, Masato; Nimura, Yuji; Kamiya, Junichi; Kondo, Shota; Kanai, Masashi

doi:10.1148/radiology.200.2.8685357

Cited by 193 publications

(117 citation statements)

References 0 publications

Supporting

Mentioning

113

Contrasting

Order By: Relevance

“…Various embolic agents have been used for the preoperative PVE of liver metastases or malignant liver tumors and there is still a debate regarding the optimal embolic material [18][19][20]. Because our previous preferred embolic agent Ethibloc was no longer available, we chose Histocryl as a replacement, because of many years of experience with the use of a Histoacryl/Lipiodol combination in the preoperative embolization of renal carcinomas.…”

Section: Discussionmentioning

confidence: 99%

Portal Vein Embolization Using a Histoacryl/Lipiodol Mixture before Right Liver Resection

et al. 2012

View full text Add to dashboard Cite

Key Word sPortal vein embolization ؒ Histoacryl/Lipiodol mixture ؒ Liver lobe volume Abst ractPur pose: The purpose of this retrospective study was to evaluate the efficacy and safety of percutaneous transhepatic portal vein embolization (PVE) of the right liver lobe using Histoacryl/Lipiodol mixture to induce contralateral liver hypertrophy before right-sided (or extended rightsided) hepatectomy in patients with primarily unresectable liver tumors. Methods: Twenty-one patients (9 females and 12 males) underwent PVE due to an insufficient future liver remnant; 17 showed liver metastases and 4 suffered from biliary cancer. Imaging was performed prior to and 4 weeks after PVE. Surgery was scheduled for 1 week after a CT or MRI control. The primary study end point was technical success, defined as complete angiographical occlusion of the portal vein. The secondary study end point was evaluation of liver hypertrophy by CT and MRI volumetry and transfer to operability. Results: In all the patients, PVE could be performed with a Histoacryl/Lipiodol mixture (n = 20) or a Histoacryl/ Lipiodol mixture with microcoils (n = 1). No procedure-related complications occurred. The volume of the left liver lobe increased significantly (p < 0.0001) by 28% from a mean of 549 ml to 709 ml. Eighteen of twenty-one patients (85.7%) could be transferred to surgery, and the intended resection could be performed as planned in 13/18 (72.3%) patients. Conclusion: Preoperative right-sided PVE using a Histoacryl/ Lipiodol mixture is a safe technique and achieves a sufficient hypertrophy of the future liver remnant in the left liver lobe.

show abstract

Section: Discussionmentioning

confidence: 99%

Portal Vein Embolization Using a Histoacryl/Lipiodol Mixture before Right Liver Resection

et al. 2012

View full text Add to dashboard Cite

show abstract

“…Embolization of portal vein supplying that part of the liver containing the tumor have been seen to reduce tumor size [14]. The main problem with tumor shrinkage is that only a small proportion of patients respond well enough to the treatment to allow secondary liver resection, or other procedure following therapy and, the responders cannot be predicted [8].…”

Section: Discussion and Review Of The Literaturementioning

confidence: 99%

Long-Term Survival of a Patient with a Large Unresectable Hepatocellular Carcinoma: Case Report and Review of the Literature~!2010-04-28~!2010-05-29~!2010-07-23~!

Karatzas¹

2010

TOSJ

View full text Add to dashboard Cite

Amongst therapies for unresectable hepatocellular carcinomas, radiofrequency ablation (RFA) and hepatic artery chemoembolization have clinical application either for local tumor destruction or to control tumor progression and recurrence rate. Herein we present a patient with a large hepatocellular carcinoma, chronic hepatitis B and congenital absence of left hepatic lobe treated with hepatic artery chemoembolization, multiple RFA sessions and transarterial chemoembolizations resulted in long-term survival far beyond actual expected survival rate, while preserving quality of life.

show abstract

“…PVE is widely used before major hepatectomy to induce hypertrophy of the future liver remnant and to reduce the risks of major hepatectomy (5,14,26,27). Several reports have analyzed the factors that affect the outcome of PVE in human clinical studies (5,34).…”

Section: Discussionmentioning

confidence: 99%

Does estrogen contribute to the hepatic regeneration following portal branch ligation in rats?

Kawai

Yokoyama²,

Kawai³

et al. 2007

American Journal of Physiology-Gastrointestinal and Liver Physi

View full text Add to dashboard Cite

.-The aim of this study was to determine whether estrogen plays any role in the hepatic regeneration of nonligated lobe following portal branch ligation (PBL). Male rats were subjected to PBL on the left and middle lobes. Two and 7 days after PBL, the rats were killed and blood and liver samples were analyzed. Sham animals underwent only laparotomy. The serum estradiol levels were significantly elevated on day 2 following PBL and returned to normal levels on day 7. The expression of estrogen receptors (ER) in the liver evaluated by Western blotting did not show any change in the nonligated lobe compared with shams. Immunohistochemical study for ER showed a predominant ER expression in the hepatocyte nucleus in periportal area (zone 1), although there was no apparent difference in the amount and expression pattern between sham and PBL. However, chronic inhibition of ER by an ER antagonist (ICI 182,780) showed a significantly lower regeneration rate of the nonligated lobe compared with vehicle treatment. Liver regeneration-associated genes also were less activated in the ICI group. Moreover, portal venous flow, determined by fluorescent microsphere injection, was significantly lower in the ICI group compared with vehicle group. These changes correlated with the attenuated expression of endothelial nitric oxide synthase mRNA in both superior mesenteric arteries and veins. In conclusion, these results indicate that the estrogen's contribution on hepatic regeneration following PBL is at least partly mediated through maintaining mesenteric blood flow by mesenteric endothelial nitric oxide synthase upregulation rather than directly activating liver regeneration in the liver. portal vein embolization; nonligated lobe; estrogen receptor; endothelial nitric oxide synthase; mesenteric flow PREOPERATIVE PORTAL VEIN EMBOLIZATION (PVE) has been performed widely before extended hepatectomy for hepatoma (21), metastatic colorectal cancer (16), and biliary cancer (27). After PVE for the hepatic lobe to be resected, the nonembolized lobe enlarges and ensures the safety of major hepatectomy. Patients in the PVE group were better than the non-PVE group with respect to lower concentration of postoperative peak bilirubin, fewer occurrence of liver failure, and shorter hospital stay (5, 12). Interestingly, a report analyzing 84 consecutive cases of PVE demonstrated that female sex is preferable in the process of hepatic regeneration (14), indicating that gender or sex hormone milieu has some influence on the regeneration rate following PVE. A better hepatic regeneration rate in female subjects was also observed after major hepatectomy (31). However, these studies were retrospective analyses of patients and thus the precise mechanism with regard to the effect of gender or sex hormone in the process of hepatic regeneration following PVE is not known.Estrogen, a representative female sex hormone, has been shown to modulate hepatic regeneration in experimental hepatectomy models (4, 6 -8). Serum concentrations of estradiol were elevated f...

show abstract

Selective percutaneous transhepatic embolization of the portal vein in preparation for extensive liver resection: the ipsilateral approach.

Cited by 193 publications

References 0 publications

Portal Vein Embolization Using a Histoacryl/Lipiodol Mixture before Right Liver Resection

Portal Vein Embolization Using a Histoacryl/Lipiodol Mixture before Right Liver Resection

Long-Term Survival of a Patient with a Large Unresectable Hepatocellular Carcinoma: Case Report and Review of the Literature~!2010-04-28~!2010-05-29~!2010-07-23~!

Does estrogen contribute to the hepatic regeneration following portal branch ligation in rats?

Contact Info

Product

Resources

About