Efficacy and safety of portal vein Embolization for two-stage Hepatectomy in patients with colorectal liver metastasis

Steven Y. Huang, Thomas A. Aloia, Junichi Shindoh, Joe Ensor, Colette M. Shaw, Evelyne M. Loyer, Jean Nicolas Vauthey, Michael J. Wallace

Research output: Contribution to journalArticle

17 Scopus citations

Abstract

Purpose To examine the efficacy and safety of portal vein embolization (PVE) when used during two-stage hepatectomy for bilobar colorectal liver metastases (CLM). Materials and Methods PVE was performed as an adjunct to two-stage hepatectomy in 56 patients with CLM. Absolute future liver remnant (FLR) volumes, standardized FLR ratios, degree of hypertrophy (DH), and complications were analyzed. Segment II and III volumes and DH were also measured separately. All volumetric measurements were compared with a cohort of 96 patients (n = 37 right portal vein embolization [RPVE], n = 59 right portal vein embolization extended to segment IV portal veins [RPVE+4]) in whom PVE was performed before single-stage hepatectomy. Results For patients who completed RPVE during two-stage hepatectomy (n = 17 of 17), mean absolute FLR volume increased from 272.1 cm3 to 427.0 cm3 (P <.0001), mean standardized FLR ratio increased from 0.17 to 0.26 (P <.0001), and mean DH was 0.094. For patients who completed RPVE+4 during two-stage hepatectomy (n = 38 of 39), mean FLR volume increased from 288.7 cm3 to 424.8 cm 3 (P <.0001), mean standardized FLR increased from 0.18 to 0.26 (P <.0001), and mean DH was 0.083. DH of the FLR was not significantly different between two-stage hepatectomy and single-stage hepatectomy. Complications after PVE occurred in five (8.9%) patients undergoing two-stage hepatectomy. Conclusions PVE effectively and safely induced a significant DH in the FLR during two-stage hepatectomy in patients with CLM.

Original languageEnglish (US)
Pages (from-to)608-617
Number of pages10
JournalJournal of Vascular and Interventional Radiology
Volume25
Issue number4
DOIs
StatePublished - Apr 2014

Keywords

  • Abbreviations
  • CLM
  • DH
  • FLR
  • PVE
  • RPVE
  • RV
  • S4
  • TLV
  • colorectal liver metastasis
  • degree of hypertrophy
  • future liver remnant
  • portal vein embolization
  • resection volume
  • right portal vein embolization
  • right portal vein embolization extended to segment IV portal veins
  • segment IV
  • segments II and III
  • total liver volume

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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