Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

Inoué, Yoshihiro; Fujii, Kensuke; Ishii, Masatsugu; Kagota, Syuji; Tomioka, Akihiro; Hamamoto, Hiroki; Osumi, Wataru; Tsuchimoto, Yusuke; Masubuchi, Shinsuke; Yamamoto, Masashi; Asai, Akira; Koyama, Koji; Shimizu, Tetsunosuke; Asakuma, Mitsuhiro; Fukunishi, Shinya; Hirokawa, Fumitoshi; Narumi, Y; Higuchi, Kazuhide; Uchiyama, Kazuhisa

doi:10.1007/s11605-018-3985-5

Cited by 22 publications

(18 citation statements)

References 24 publications

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“…So, patients who underwent right hemihepatectomy were taken for granted less FLRV and remnant liver volume. With the improvement of perioperative management and hepatic surgery technology, the occurrence of postoperative complication and PHLF have a close relationship with the less remnant liver volume [33]. Our research results were consistent with those published results.…”

Section: Discussionsupporting

confidence: 90%

Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma

Gong

Zhong

et al. 2019

Bioscience Reports

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Aim: To explore clinical factors associated with extent of liver regeneration after hemihepatectomy to treat hepatocellular carcinoma (HCC). Methods: Future liver remnant volume (as a percentage of functional liver volume, %FLRV) and remnant liver volume were measured preoperatively and at 1, 5, 9, and 13 weeks postoperatively. Results: After hepatectomy, 1 of 125 patients (0.8%) died within 3 months, 13 (10.4%) experienced liver failure, and 99 (79.2%) experienced complications. %FLRV was able to predict liver failure with an area under the receiver operating characteristic curve of 0.900, and a cut-off value of 42.7% showed sensitivity of 85.7% and specificity of 88.6%. Postoperative median growth ratio was 21.3% at 1 week, 30.9% at 5 weeks, 34.6% at 9 weeks, and 37.1% at 13 weeks. Multivariate analysis identified three predictors associated with liver regeneration: FLRV < 601 cm3, %FLRV, and liver cirrhosis. At postoperative weeks (POWs) 1 and 5, liver function indicators were significantly better among patients showing high extent of regeneration than among those showing low extent, but these differences disappeared by POW 9. Conclusions: FLRV, %FLRV, and liver cirrhosis strongly influence extent of liver regeneration after hepatectomy. %FLRV values below 42.7% are associated with greater risk of post-hepatectomy liver failure.

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Section: Discussionsupporting

confidence: 90%

Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma

Gong

Zhong

et al. 2019

Bioscience Reports

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“…All procedures were performed with patients under general anaesthesia. The detailed open and laparoscopic surgical techniques routinely used in our department have been described in previous reports [ 4 , 8 – 11 ]. Briefly, standard diagnostic and staging laparotomy was conducted.…”

Section: Methodsmentioning

confidence: 99%

Efficacy and safety of laparoscopic hepatectomy for hepatocellular carcinoma comorbid with cirrhosis

Inoué

Yokohama²,

Ohama³

et al. 2020

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Introduction Laparoscopic hepatectomy (LH) is very difficult to perform in patients with cirrhosis because of the haemorrhagic and fibrotic nature of the liver, although there are various advantages to laparoscopic surgery. Aim To investigate the surgical outcomes, and efficacy and safety of LH versus open hepatectomy (OH) for hepatocellular carcinoma (HCC) resection. Material and methods A total of 112 patients with cirrhosis, who underwent hepatectomy, were analysed retrospectively. We investigated the safety and efficacy of LH for HCC with cirrhosis. Student’s t and χ 2 tests, Mann-Whitney’s U test, Wilcoxon’s signed-rank test, and Fisher’s exact test were used in the statistical analysis. Results Seventy-one patients underwent LH, and 41 underwent OH. The conversion rate from LH to OH was 12.7%. After propensity score matching, the estimated blood loss was significantly lower in the LH group than in the OH group (25 vs. 310 ml; p < 0.001), and there was a significant difference between the groups in the operative time ( p = 0.091). The LH group had complication rates of 3.6% and 0% for refractory ascites and pleural effusion, respectively, while those were 17.9% and 10.7%, respectively, in the OH group ( p = 0.019 and p = 0.005, respectively). The LH group had no mortality, whereas the OH group had a mortality rate of 10.7% ( p = 0.038). The postoperative length of stay was significantly longer in the LH group than in the OH group (9 days vs. 14 days) ( p = 0.002). Conclusions LH can be performed safely for HCC with cirrhosis. More favourable results are achieved with LH than with OH in terms of surgical outcomes.

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“…The liver can regenerate to recover the original mass once it is removed surgically [ 1 , 2 ]. In clinical settings, liver resection is required to remove liver tumors or to donate for living organ transplantation [ 3 , 4 ].…”

Section: Introductionmentioning

confidence: 99%

Nature of the liver volume depending on the gender and age assessing volumetry from a reconstruction of the computed tomography

et al. 2021

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Although the liver is a regenerating organ, excessive loss of liver volume (LV) can cause fatal liver failure. It is unclear whether LV is correlated with age; however, it is known that liver function decreases with age. In addition, the gender-related role of LV remains unclear. This study aimed to investigate the changes in LV by age and gender. Between January and December 2018, 374 consecutive patients who underwent abdominal multidetector computed tomography (MDCT) for any abdominal examinations were enrolled. LV was evaluated using MDCT. The relationship between the LV and body mass index (BMI), body surface area (BSA), age, and gender was investigated. The modified LV (mLV) was calculated by a formula measured LV × 1.5/BSA. LV correlated to BSA more than to BMI in both the males (R: 0.559 vs. 0.416) and females (R: 0.479 vs. 0.300) in our study. Age was negatively correlated to LV and BSA, and correlated to LV more than to BSA in males (R: 0.546 vs. 0.393) and females (R: 0.506 vs. 0.385). In addition, the absolute slope between age and LV in the males was higher than that in the females (14.1 vs. 10.2, respectively). Furthermore, the absolute slope of age and mLV in the males was slightly higher than in the females (9.1 vs. 7.3, respectively). In conclusion, LV in the normal liver is correlated to age rather than the one in the diseased liver. Liver volume in the males decreased more with age than LV in the females.

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Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

Cited by 22 publications

References 24 publications

Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma

Evaluation of liver regeneration and post-hepatectomy liver failure after hemihepatectomy in patients with hepatocellular carcinoma

Efficacy and safety of laparoscopic hepatectomy for hepatocellular carcinoma comorbid with cirrhosis

Nature of the liver volume depending on the gender and age assessing volumetry from a reconstruction of the computed tomography

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