Percutaneous Radiofrequency Assisted Liver Partition With Portal Vein Embolization for Staged Hepatectomy (Pralpps)

Giménez, Mariano Eduardo; Houghton, Eduardo Javier; Davrieux, Carlos Federico; Serra, Edgardo; Pessaux, Patrick; Palermo, Mariano; Acquafresca, Pablo; Finger, Caetano; Dallemagne, Bernard; Marescaux, Jacques

doi:10.1590/0102-672020180001e1346

Cited by 10 publications

(10 citation statements)

References 26 publications

(27 reference statements)

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“…A similar approach using percutaneous PVE and microwave ablation has been described 27 , but percutaneous RFA with PVE as an original technique has been demonstrated only in an experimental study in pigs (PRALPPS) 28 . A similar approach using percutaneous PVE and microwave ablation has been described 27 , but percutaneous RFA with PVE as an original technique has been demonstrated only in an experimental study in pigs (PRALPPS) 28 .…”

Section: Discussionmentioning

confidence: 99%

Percutaneous radiofrequency-assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma

et al. 2020

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Background: Percutaneous radiofrequency-assisted liver partition with portal vein embolization in staged liver resection (PRALPPS) represents an alternative to portal vein embolization (PVE) followed by major liver resection in patients with perihilar cholangiocarcinoma.Methods: This was an observational case-control study. Both procedures were applied in patients with a future liver remnant (FLR) volume of less than 40 per cent. The main end points of the study were short-term morbidity and mortality for the two procedures. The study also compared the efficacy of the preresection phases estimated by kinetic growth rate (KGR), time interval and degree of hypertrophy of the FLR.Results: The first phase (preresection) was completed in 11 and 18 patients, and the second phase (resection) in nine and 14 patients, in the PRALPPS and PVE groups respectively. Major morbidity after the first stage did not differ between the groups. There were no differences in blood loss, severe morbidity or liver failure rate after the second stage, with no deaths. The mean KGR of the FLR after the preresection phase for PRALPPS was 3⋅8 (0⋅6-9⋅8) per cent/day, and that after PVE was 1⋅8 (0-6⋅7) per cent/day (P = 0⋅037). The mean time interval for FLR hypertrophy in the PRALPPS and PVE groups was 15 (6-29) and 20 (8-35) days respectively (P = 0⋅039).Conclusion: Short-term outcomes were similar for PRALPPS and PVE in terms of safety. Remnant hypertrophy was achieved more rapidly by PRALPPS.

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Section: Discussionmentioning

confidence: 99%

Percutaneous radiofrequency-assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma

et al. 2020

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“…In portal hypertension it is observed an increase in vascular resistance in the portal vein and its tributaries. An important drainage route of the portal system to the systemic circulation occurs with the inversion of blood flow in the left gastric vein and the vessels of the submucosa of the stomach and esophagus 4 . Seeking to decrease the pressure, dilation and tortuosity of the veins occurs, leading to a hyperdynamic circulatory state associated with the release of vasoactive substances.…”

Section: Discussionmentioning

confidence: 99%

Carvedilol as Primary Prophylaxis for Gastric Variceal Bleeding in Portal Hypertension Model in Rats

Bertoldi

Guetter

Coltro

et al. 2020

ABCD, arq. bras. cir. dig.

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Background: Portal hypertension (PH) can be measured indirectly through a hepatic vein pressure gradient greater than 5 mmHg. Cirrhosis is the leading cause for PH and can present as complications ascites, hepatic dysfunction, renal dysfunction, and esophagogastric varices, characterizing gastropathy. Aim: To evaluate the use of carvedilol as primary prophylaxis in the development of collateral circulation in rats submitted to the partial portal vein ligament (PPVL) model. Method: This is a combined qualitative and quantitative experimental study in which 32 Wistar rats were divided into four groups (8 animals in each): group I - cirrhosis + carvedilol (PPVL + C); group II - cirrhosis + vehicle (PPVL); group III - control + carvedilol (SO-sham-operated + C); group IV - control + vehicle (SO-sham-operated). After seven days of the surgical procedure (PPVL or sham), carvedilol (10 mg/kg) or vehicle (1 mL normal saline) were administered to the respective groups daily for seven days. Results: The histological analysis showed no hepatic alteration in any group and a decrease in edema and vasodilatation in the PPVL + C group. The laboratory evaluation of liver function did not show a statistically significant change between the groups. Conclusion: Carvedilol was shown to have a positive effect on gastric varices without significant adverse effects.

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“…This technique first described by Gall [60] uses a radiofrequency ablation device to create a line of coagulative necrosis in the hepatic parenchyma instead of physical transection. In experimental study in animals, the procedure has also been performed percutaneously (percutaneous radiofrequency-assisted liver partition with portal vein ligation (PRALPPS)) [61].…”

Section: Associating Liver Partition and Portal Vein Ligation For Twomentioning

confidence: 99%

How to Treat Bilobar Liver Metastases: New Surgical Challenges

Uggeri¹,

Pinotti²,

Garancini³

et al. 2019

Liver Disease and Surgery [Working Title]

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To date, the improvements in survival of patients with liver metastases and advances in technology allowed the surgical indications to be extended. In complex cases, however, the possibility of performing a curative hepatic resection collides with the need to preserve a sufficient liver volume to avoid a postoperative hepatic failure. Currently postoperative liver failure is the major cause of death for these patients. In the attempt to overcome this limit in the last decades, we tried to introduce new measures and develop new surgical techniques. From the introduction by Makuuchi in the 1980s of the preoperative portal embolization, many surgical techniques have been proposed and perfected. The aim of this chapter is to describe the new surgical techniques for the approach of complex hepatic metastases.

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Percutaneous Radiofrequency Assisted Liver Partition With Portal Vein Embolization for Staged Hepatectomy (Pralpps)

Cited by 10 publications

References 26 publications

Percutaneous radiofrequency-assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma

Percutaneous radiofrequency-assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma

Carvedilol as Primary Prophylaxis for Gastric Variceal Bleeding in Portal Hypertension Model in Rats

How to Treat Bilobar Liver Metastases: New Surgical Challenges

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