Increase in future remnant liver function after preoperative portal vein embolization

Graaf, Wilmar de; Lienden, Krijn P. van; Esschert, Jacomina W. van den; Bennink, Roelof J.; Gulik, Thomas M. van

doi:10.1002/bjs.7456

Cited by 150 publications

(98 citation statements)

References 32 publications

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“…Some studies postulate that liver regeneration is promoted at the expense of liver function, resulting in prolonged and less functional regeneration compared with the rapid increase in FLR volume [4e6]. Other works, based on nuclear imaging techniques (i.e., hepatobiliary scintigraphy [7] or hepatocyte mass scintigraphy [8,9]), indicate that increase in FLR function is more pronounced than implied by the degree of morphologic regeneration. This hypothesis, however, has not yet been confirmed by other widely accepted quantitative liver function tests.…”

Section: Introductionmentioning

confidence: 99%

Alterations in hepatic lobar function in regenerating rat liver

Fülöp

Budai

Czigány

et al. 2015

Journal of Surgical Research

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Section: Introductionmentioning

confidence: 99%

Alterations in hepatic lobar function in regenerating rat liver

Fülöp

Budai

Czigány

et al. 2015

Journal of Surgical Research

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“…However, as mentioned earlier, volume is not necessarily representative of FRL function. Recently, a discrepancy between the volumetric and functional changes after PVE has been described where FRL functional increase exceeded the volumetric increase [11]. …”

Section: Volumetric Measurement Techniques: the Gold Standard And Novmentioning

confidence: 99%

“…FRL volume does not reflect the function of the FRL, which might be impaired by underlying parenchymal disease or hepatic comorbidity such as fibrosis, cirrhosis, or steatosis. It is important to identify patients with a compromised liver in order to interpret the volumetry results correctly [11]. This has become even more important since many patients are now presented for resection after extensive induction or neoadjuvant chemotherapy, whereby liver parenchyma can be injured by postchemotherapy steatosis or veno-occlusive disease [12].…”

Section: Volumetric Measurement Techniques: the Gold Standard And Novmentioning

confidence: 99%

New Perspectives in the Assessment of Future Remnant Liver

Cieslak¹,

Runge

Heger³

et al. 2014

Dig Surg

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In order to achieve microscopic radical resection margins and thus better survival, surgical treatment of hepatic tumors has become more aggressive in the last decades, resulting in an increased rate of complex and extended liver resections. Postoperative outcomes mainly depend on the size and quality of the future remnant liver (FRL). Liver resection, when performed in the absence of sufficient FRL, inevitably leads to postresection liver failure. The current gold standard in the preoperative assessment of the FRL is computed tomography volumetry. In addition to the volume of the liver remnant after resection, postoperative function of the liver remnant is directly related to the quality of liver parenchyma. The latter is mainly influenced by underlying diseases such as cirrhosis and steatosis, which are often inaccurately defined until microscopic examination after the resection. Postresection liver failure remains a point of major concern that calls for accurate methods of preoperative FRL assessment. A wide spectrum of tests has become available in the past years, attesting to the fact that the ideal methodology has yet to be defined. The aim of this review is to discuss the current modalities available and new perspectives in the assessment of FRL in patients scheduled for major liver resection. i 2014 S. Karger AG, Basel

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“…1 Strategies to avoid an insufficient remnant liver include staged resection (two-stage hepatectomy, 4 associating liver partition and portal vein ligation for staged hepatectomy (ALPPS)), 5 and portal vein embolization (PVE). 6 Postoperative treatments lack and only intensive support can be provided when PLF occurs. It is therefore essential to have an accurate postoperative clinical risk indicator that can predict PLF to provide early optimal support.…”

Section: Plfmentioning

confidence: 99%