Portal vein embolization induces compensatory hypertrophy of remnant liver

Huang, Jinke; Weizhu, Yang; Li, Jianjun; Jiang, Na; Qubin, Zheng

doi:10.3748/wjg.v12.i3.408

Cited by 24 publications

(27 citation statements)

References 27 publications

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“…The use of reversible PVE to ensure vascular occlusion over 2 weeks should therefore induce the required hypertrophy without long-term deleterious effects. Reversible PVE has been used in a few clinical and experimental studies, but was reported to induce insufficient hepatic regeneration [20,21]. This was probably due to early revascularization of the embolized portal branches.…”

Section: Introductionmentioning

confidence: 99%

Liver regeneration and recanalization time course following reversible portal vein embolization

Laïnas

Boudechiche

Osorio

et al. 2008

Journal of Hepatology

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Section: Introductionmentioning

confidence: 99%

Liver regeneration and recanalization time course following reversible portal vein embolization

Laïnas

Boudechiche

Osorio

et al. 2008

Journal of Hepatology

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“…Although gelatin sponges are widely available and easy to use for PVE, the recanalization rate after PVE using gelatin sponge in ten dogs was 100% [23], and there have been case reports showing with recanalization following PVE with gelatin sponges [3,4,24]. We found that three of the four patients with recanalized PVs were embolized with gelatin sponges alone, further indicating the need for additional coils following gelatin sponges to prevent recanalization [5,7].…”

Section: Discussionmentioning

confidence: 71%

Preoperative portal vein embolization using an amplatzer vascular plug

Yoo

Gwon

et al. 2008

Eur Radiol

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The purpose was to evaluate the safety and efficacy of preoperative portal vein embolization (PVE) using an Amplatzer vascular plug (AVP). Forty-one patients who underwent PVE using gelatin sponge particles and the AVP were enrolled. The right portal branches were embolized using gelatin sponges (1-8 mm(3)) through a 5-F catheter, and the AVP was deployed at the first- or second-order right portal vein. Technical success and complications, recanalization, and changes of total estimated liver volumes (TELV), future liver remnant (FLR), and FLR/TELV were evaluated. Follow-up CT performed 6-43 days (median, 16 days) after PVE was used to evaluate volume parameters. PVE was technically successful in 40 of 41 patients. Major complications occurred in two patients, with one each having extensive portal vein thrombosis and liver abscess. Partial recanalization of the occluded portal vein was seen in one patient. The mean FLR volume (653 +/- 174 ml vs. 532 +/- 154 ml, p < 0.001) and mean FLR/TELV ratio (43 +/- 8% vs 36 +/- 7%, p < 0.001) were significantly higher after than before PVE. PVE using the AVP seems to be a relatively safe and effective technique for inducing hypertrophy of the FLR with minimal risk of recanalization.

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“…This method has been first applied in a clinical scenario by Makuuchi et al [4] to enhance the safety of extended hepatectomy. Later, the technique has been widely spread in the experimental field as well, especially in large animal models [10,11,12,13] (table 1). …”

Section: Pvo Modelsmentioning

confidence: 99%

Triggered Liver Regeneration: From Experimental Model to Clinical Implications

Szíjártó

Fülöp

2015

Eur Surg Res

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Background: Major liver resection is the only therapeutic option for patients with malignant liver tumors. However, extended hepatectomy often leads to postoperative liver failure, mainly due to insufficient amounts of the remnant liver. Recently, selective portal vein occlusion (PVO) has been introduced to increase the remnant liver volume. This novel surgical technique initiated a progressive development in liver surgery, resulting in a significant increment in potential candidates for curative liver resection. Summary: The theoretical basis for this great advancement is formed by an understanding of the mechanisms of PVO-induced liver regeneration, mainly obtained from animal studies. The aim of this review is to give a comprehensive overview of the relevant animal models of PVO and to discuss the main characteristics of triggered liver regeneration, including the induced hemodynamic, morphological and functional alterations as well as the underlying molecular mechanisms, which might be of interest in both the laboratory and the clinic. Key Messages: Although basic research revealed the main characteristics of PVO-triggered liver regeneration within the last decades, several important issues regarding the regenerative process remain uncertain. To answer these open questions, additional well-designed animal experiments are needed in the future, which allow further refinement of this surgical technique.

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Portal vein embolization induces compensatory hypertrophy of remnant liver

Abstract: Portal vein branch embolization using absolute ethanol and coil-gelfoam could induce atrophy of the embolized lobes and compensatory hypertrophy of the remnant liver. Gelfoam is an inefficient agent.

Cited by 24 publications

References 27 publications

Liver regeneration and recanalization time course following reversible portal vein embolization

Liver regeneration and recanalization time course following reversible portal vein embolization

Preoperative portal vein embolization using an amplatzer vascular plug

Triggered Liver Regeneration: From Experimental Model to Clinical Implications

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