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Article: Portal vein embolisation prior to extended right-sided hepatic resection

TitlePortal vein embolisation prior to extended right-sided hepatic resection
Authors
KeywordsCarcinoma, hepatocellular
Cholangiocarcinoma
Embolization, therapeutic
Hepatectomy
Portal vein
Issue Date2005
PublisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.html
Citation
Hong Kong Medical Journal, 2005, v. 11 n. 5, p. 366-372 How to Cite?
AbstractObjectives. To determine whether preoperative portal vein embolisation improves the operative outcome of patients undergoing extended right-sided hepatic resection for hepatobiliary malignancy. Design. Prospective non-randomised study. Setting. University teaching hospital, Hong Kong. Patients. Ninety-two patients underwent extended right-sided hepatic resection for hepatobiliary malignancy during a 45-month period (January 2000 to September 2003). Among them, 15 (16%) underwent portal vein embolisation via a percutaneous ipsilateral approach (n=9) or through the ileocolic vein with a mini-laparotomy (n=6). The remaining 77 (84%) patients underwent hepatic resection without portal vein embolisation. Main outcome measures. Operative morbidity and mortality. Results. Patients undergoing portal vein embolisation were older (69 years vs 55 years; P=0.009), and had significantly worse preoperative renal function (creatinine, 96 μmol/L vs 86 μmol/L; P=0.039) and liver function (bilirubin, 23 μmol/L vs 12 μmol/L; P<0.001). Portal vein embolisation resulted in an increase in the future liver remnant of 9% (interquartile range, 7-13%) of the estimated standard liver volume. The operating time for patients receiving portal vein embolisation was significantly longer (medium, 660 min vs 420 min; P<0.001) with more complicated surgery performed in terms of concomitant caudate lobectomy and hepaticojejunostomy. There was no hospital mortality in patients who underwent portal vein embolisation whereas five without the treatment died (P=0.587). The operative morbidity of patients who underwent portal vein embolisation and those who did not was 20% and 30%, respectively (P=0.543). Conclusions. In older patients who have worse preoperative liver and renal functions, portal vein embolisation enhances the possibility to perform extended right-sided hepatic resection for hepatobiliary malignancies with potentially lower operative mortality and morbidity.
Persistent Identifierhttp://hdl.handle.net/10722/44649
ISSN
2015 Impact Factor: 0.887
2015 SCImago Journal Rankings: 0.279
References

 

DC FieldValueLanguage
dc.contributor.authorLiem, MSLen_HK
dc.contributor.authorLiu, CLen_HK
dc.contributor.authorTso, WKen_HK
dc.contributor.authorLo, CMen_HK
dc.contributor.authorFan, STen_HK
dc.contributor.authorWong, Jen_HK
dc.date.accessioned2007-10-30T06:06:51Z-
dc.date.available2007-10-30T06:06:51Z-
dc.date.issued2005en_HK
dc.identifier.citationHong Kong Medical Journal, 2005, v. 11 n. 5, p. 366-372en_HK
dc.identifier.issn1024-2708en_HK
dc.identifier.urihttp://hdl.handle.net/10722/44649-
dc.description.abstractObjectives. To determine whether preoperative portal vein embolisation improves the operative outcome of patients undergoing extended right-sided hepatic resection for hepatobiliary malignancy. Design. Prospective non-randomised study. Setting. University teaching hospital, Hong Kong. Patients. Ninety-two patients underwent extended right-sided hepatic resection for hepatobiliary malignancy during a 45-month period (January 2000 to September 2003). Among them, 15 (16%) underwent portal vein embolisation via a percutaneous ipsilateral approach (n=9) or through the ileocolic vein with a mini-laparotomy (n=6). The remaining 77 (84%) patients underwent hepatic resection without portal vein embolisation. Main outcome measures. Operative morbidity and mortality. Results. Patients undergoing portal vein embolisation were older (69 years vs 55 years; P=0.009), and had significantly worse preoperative renal function (creatinine, 96 μmol/L vs 86 μmol/L; P=0.039) and liver function (bilirubin, 23 μmol/L vs 12 μmol/L; P<0.001). Portal vein embolisation resulted in an increase in the future liver remnant of 9% (interquartile range, 7-13%) of the estimated standard liver volume. The operating time for patients receiving portal vein embolisation was significantly longer (medium, 660 min vs 420 min; P<0.001) with more complicated surgery performed in terms of concomitant caudate lobectomy and hepaticojejunostomy. There was no hospital mortality in patients who underwent portal vein embolisation whereas five without the treatment died (P=0.587). The operative morbidity of patients who underwent portal vein embolisation and those who did not was 20% and 30%, respectively (P=0.543). Conclusions. In older patients who have worse preoperative liver and renal functions, portal vein embolisation enhances the possibility to perform extended right-sided hepatic resection for hepatobiliary malignancies with potentially lower operative mortality and morbidity.en_HK
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dc.languageengen_HK
dc.publisherHong Kong Medical Association. The Journal's web site is located at http://www.hkmj.org/resources/supp.htmlen_HK
dc.relation.ispartofHong Kong Medical Journalen_HK
dc.rightsCreative Commons: Attribution 3.0 Hong Kong License-
dc.subjectCarcinoma, hepatocellularen_HK
dc.subjectCholangiocarcinomaen_HK
dc.subjectEmbolization, therapeuticen_HK
dc.subjectHepatectomyen_HK
dc.subjectPortal veinen_HK
dc.subject.meshBiliary Tract Neoplasms - therapyen_HK
dc.subject.meshEmbolization, Therapeutic - methodsen_HK
dc.subject.meshLiver Neoplasms - therapyen_HK
dc.subject.meshPortal Veinen_HK
dc.subject.meshStatistics, Nonparametricen_HK
dc.titlePortal vein embolisation prior to extended right-sided hepatic resectionen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=1024-2708&volume=11&issue=5&spage=366&epage=372&date=2005&atitle=Portal+vein+embolisation+prior+to+extended+right-sided+hepatic+resectionen_HK
dc.identifier.emailLo, CM: chungmlo@hkucc.hku.hken_HK
dc.identifier.emailFan, ST: stfan@hku.hken_HK
dc.identifier.emailWong, J: jwong@hkucc.hku.hken_HK
dc.identifier.authorityLo, CM=rp00412en_HK
dc.identifier.authorityFan, ST=rp00355en_HK
dc.identifier.authorityWong, J=rp00322en_HK
dc.description.naturepublished_or_final_versionen_HK
dc.identifier.pmid16219956-
dc.identifier.scopuseid_2-s2.0-27144464136en_HK
dc.identifier.hkuros116494-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-27144464136&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume11en_HK
dc.identifier.issue5en_HK
dc.identifier.spage366en_HK
dc.identifier.epage372en_HK
dc.publisher.placeHong Kongen_HK
dc.identifier.scopusauthoridLiem, MSL=7003681583en_HK
dc.identifier.scopusauthoridLiu, CL=7409789712en_HK
dc.identifier.scopusauthoridTso, WK=7006905486en_HK
dc.identifier.scopusauthoridLo, CM=7401771672en_HK
dc.identifier.scopusauthoridFan, ST=7402678224en_HK
dc.identifier.scopusauthoridWong, J=8049324500en_HK

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