Abstract
Background/Purpose: Preoperative portal vein embolization was introduced to minimize complications after extended hepatectomy. This retrospective cohort study was conducted to compare outcomes with and without portal vein embolization before hepatectomy for hilar cholangiocellular carcinoma. Methods: This study was conducted with 35 patients who underwent right extended hemihepatectomy for hilar cholangiocellular carcinoma from 2001 to 2008. Preoperative portal vein embolization was performed in 14 patients (embolization group) and not performed in 21 patients (non-embolization group). Results: The groups did not differ in terms of sex, age, operative time, transfusion, postoperative serum bilirubin level, prothrombin time, and length of intensive care unit (ICU) stay. Although blood loss was higher in the embolization group than in the non-embolization group (P = .009), no major complications were observed between embolization and resection. At presentation, future liver remnant was smaller in the embolization group (19.8%, range 16-35%) than in non-embolization group (28.3%, 15-47%; P = .001). After embolization, the volume of the future liver remnant increased significantly to 27.2% (range, 23-42%; P = .001). Future liver remnants just before operation were similar in both groups (P > .99). There was no significant difference in terms of the rate of morbidity and in-hospital mortality. No statistically significant differences were observed in disease-free survival (P = .52) and overall survival (P = .30). Conclusions: Portal vein embolizations do not increase the rate of morbidity, in-hospital mortality, local recurrence and system metastasis. Therefore it can be considered safe and effective for patients with small future liver remnants. Embolization can lessen postoperative liver failure and widen the indication of the surgical resection, especially in patients with marginal future liver remnants.
| Original language | English |
|---|---|
| Pages (from-to) | 237-244 |
| Number of pages | 8 |
| Journal | European Journal of Surgical Oncology |
| Volume | 37 |
| Issue number | 3 |
| DOIs | |
| Publication status | Published - 2011 Mar 1 |
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Keywords
- Extended hemihepatectomy
- Hilar cholangiocellular carcinoma
- Portal vein embolization
ASJC Scopus subject areas
- Surgery
- Oncology
Cite this
The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma : A retrospective cohort study. / Hong, Y. K.; Choi, Sae-Byeol; Lee, K. H.; Park, S. W.; Park, Y. N.; Choi, J. S.; Lee, W. J.; Chung, J. B.; Kim, K. S.
In: European Journal of Surgical Oncology, Vol. 37, No. 3, 01.03.2011, p. 237-244.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma
T2 - A retrospective cohort study
AU - Hong, Y. K.
AU - Choi, Sae-Byeol
AU - Lee, K. H.
AU - Park, S. W.
AU - Park, Y. N.
AU - Choi, J. S.
AU - Lee, W. J.
AU - Chung, J. B.
AU - Kim, K. S.
PY - 2011/3/1
Y1 - 2011/3/1
N2 - Background/Purpose: Preoperative portal vein embolization was introduced to minimize complications after extended hepatectomy. This retrospective cohort study was conducted to compare outcomes with and without portal vein embolization before hepatectomy for hilar cholangiocellular carcinoma. Methods: This study was conducted with 35 patients who underwent right extended hemihepatectomy for hilar cholangiocellular carcinoma from 2001 to 2008. Preoperative portal vein embolization was performed in 14 patients (embolization group) and not performed in 21 patients (non-embolization group). Results: The groups did not differ in terms of sex, age, operative time, transfusion, postoperative serum bilirubin level, prothrombin time, and length of intensive care unit (ICU) stay. Although blood loss was higher in the embolization group than in the non-embolization group (P = .009), no major complications were observed between embolization and resection. At presentation, future liver remnant was smaller in the embolization group (19.8%, range 16-35%) than in non-embolization group (28.3%, 15-47%; P = .001). After embolization, the volume of the future liver remnant increased significantly to 27.2% (range, 23-42%; P = .001). Future liver remnants just before operation were similar in both groups (P > .99). There was no significant difference in terms of the rate of morbidity and in-hospital mortality. No statistically significant differences were observed in disease-free survival (P = .52) and overall survival (P = .30). Conclusions: Portal vein embolizations do not increase the rate of morbidity, in-hospital mortality, local recurrence and system metastasis. Therefore it can be considered safe and effective for patients with small future liver remnants. Embolization can lessen postoperative liver failure and widen the indication of the surgical resection, especially in patients with marginal future liver remnants.
AB - Background/Purpose: Preoperative portal vein embolization was introduced to minimize complications after extended hepatectomy. This retrospective cohort study was conducted to compare outcomes with and without portal vein embolization before hepatectomy for hilar cholangiocellular carcinoma. Methods: This study was conducted with 35 patients who underwent right extended hemihepatectomy for hilar cholangiocellular carcinoma from 2001 to 2008. Preoperative portal vein embolization was performed in 14 patients (embolization group) and not performed in 21 patients (non-embolization group). Results: The groups did not differ in terms of sex, age, operative time, transfusion, postoperative serum bilirubin level, prothrombin time, and length of intensive care unit (ICU) stay. Although blood loss was higher in the embolization group than in the non-embolization group (P = .009), no major complications were observed between embolization and resection. At presentation, future liver remnant was smaller in the embolization group (19.8%, range 16-35%) than in non-embolization group (28.3%, 15-47%; P = .001). After embolization, the volume of the future liver remnant increased significantly to 27.2% (range, 23-42%; P = .001). Future liver remnants just before operation were similar in both groups (P > .99). There was no significant difference in terms of the rate of morbidity and in-hospital mortality. No statistically significant differences were observed in disease-free survival (P = .52) and overall survival (P = .30). Conclusions: Portal vein embolizations do not increase the rate of morbidity, in-hospital mortality, local recurrence and system metastasis. Therefore it can be considered safe and effective for patients with small future liver remnants. Embolization can lessen postoperative liver failure and widen the indication of the surgical resection, especially in patients with marginal future liver remnants.
KW - Extended hemihepatectomy
KW - Hilar cholangiocellular carcinoma
KW - Portal vein embolization
UR - http://www.scopus.com/inward/record.url?scp=79851516882&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=79851516882&partnerID=8YFLogxK
U2 - 10.1016/j.ejso.2010.12.010
DO - 10.1016/j.ejso.2010.12.010
M3 - Article
VL - 37
SP - 237
EP - 244
JO - European Journal of Surgical Oncology
JF - European Journal of Surgical Oncology
SN - 0748-7983
IS - 3
ER -