The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma

A retrospective cohort study

Y. K. Hong, Sae-Byeol Choi, K. H. Lee, S. W. Park, Y. N. Park, J. S. Choi, W. J. Lee, J. B. Chung, K. S. Kim

Research output: Contribution to journalArticle

15 Citations (Scopus)

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 languageEnglish
Pages (from-to)237-244
Number of pages8
JournalEuropean Journal of Surgical Oncology
Volume37
Issue number3
DOIs
Publication statusPublished - 2011 Mar 1

Fingerprint

Cholangiocarcinoma
Portal Vein
Cohort Studies
Retrospective Studies
Liver
Hepatectomy
Hospital Mortality
Morbidity
Prothrombin Time
Liver Failure
Operative Time
Bilirubin
Disease-Free Survival
Intensive Care Units
Neoplasm Metastasis
Recurrence
Survival
Serum

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 journalArticle

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. / The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma : A retrospective cohort study. In: European Journal of Surgical Oncology. 2011 ; Vol. 37, No. 3. pp. 237-244.
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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.",
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