Portal Vein Embolization Utilizing N-Butyl Cyanoacrylate for Contralateral Lobe Hypertrophy Prior to Liver Resection: A Systematic Review and Meta-Analysis

Wajswol, Ethan; Jazmati, Tarek; Contractor, Sohail; Kumar, Abhishek

doi:10.1007/s00270-018-1964-6

Cited by 27 publications

(37 citation statements)

References 29 publications

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“…Although the resectability rate appears low, it is similar to previous literature. [20212223] In this study, adequate FLR hypertrophy after PVE was achieved in all patients before surgery. Only one patient with cirrhosis developed transient liver insufficiency after extended right hepatectomy for hilar cholangiocarcinoma.…”

Section: Discussionmentioning

confidence: 78%

“…This result is comparable to the other previous study. [182122232526] Most of our patients had no fever except three patients following PVE. Partial main portal vein thrombosis in one patient, bile leak causing biloma in one patient, and minor non-target embolization in three patients were found in our study.…”

Section: Discussionmentioning

confidence: 80%

“…[18192021] Few previous studies reported that hardening of vein and difficulty in tissue resection occurred after PVE with NBCA because of its strong inflammatory reaction and subsequent fibrosis. [5622]…”

Section: Discussionmentioning

confidence: 99%

“…The technical success rate of PVE in this study was 100%, which is similar to previous studies. [182122]…”

Section: Discussionmentioning

confidence: 99%

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Safety and outcomes of pre-operative portal vein embolization using N-butyl cyanoacrylate (Glue) in hepatobiliary malignancies: A single center retrospective analysis

Mukund

Mondal

Patidar

et al. 2019

Indian Journal of Radiology and Imaging

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Aims and Objectives: To evaluate the outcome of preoperative portal vein embolization (PVE) using N-butyl cyanoacrylate (NBCA) for change in future liver remnant (FLR) volume, biochemical changes, and procedure-related complications. The factors affecting FLR hypertrophy and the rate of resection was also evaluated for this cohort. Materials and Methods: From 2012 to 2017, PVE utilizing NBCA mixed with lipiodol (1:4) was performed using percutaneous approach in 28 patients with hepatobiliary malignancies with low FLR. All patients underwent volumetric computed tomography (CT) assessment before and at 3–5 weeks after PVE and total liver volume (TLV), FLR volume, and FLR/TLV ratio, changes in portal vein diameter and factors affecting FLR were evaluated. Complications and the resectability rate were recorded and analyzed. Result: PVE was successful in all 28 patients. The mean FLR increased by 52% ± 32% after PVE ( P < 0.0001). The FLR/TLV ratio was increased by 14.2% ± 2.8% ( P < 0.001). Two major complications were encountered without any impact on surgery. There was no significant change seen in liver function test and complete blood counts after PVE. Eighteen patients (64.28%) underwent hepatic resection without any liver failure, and only three patients developed major complication after surgery. Remaining ten patients did not undergo surgery because of extrahepatic metastasis detected either on follow-up imaging or staging laparotomy. Patients with diabetes showed a lower rate of hypertrophy ( P < 0.05). Conclusion: Preoperative PVE with NBCA is safe and effective for increasing FLR volume in patients of all age group and even in patients with an underlying liver parenchymal disease with hepatobiliary malignancy. Lesser hypertrophy was noted in patients with diabetes. A reasonable resectability was achieved despite having a high rejection in gall bladder cancer subgroup due to rapid disease progression.

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 80%

Section: Discussionmentioning

confidence: 99%

“…The technical success rate of PVE in this study was 100%, which is similar to previous studies. [182122]…”

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Safety and outcomes of pre-operative portal vein embolization using N-butyl cyanoacrylate (Glue) in hepatobiliary malignancies: A single center retrospective analysis

Mukund

Mondal

Patidar

et al. 2019

Indian Journal of Radiology and Imaging

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“…Portal vein embolization (PVE) of the right-sided branches of the portal vein is nowadays a routine procedure for patients undergoing (extended) right hemihepatectomy in Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00270-020-02416-6) contains supplementary material, which is available to authorized users. & M. Schulze-Hagen mschulze@ukaachen.de order to induce hypertrophy of the left liver lobe/future liver remnant (FLR) and prevent postoperative liver insufficiency [1,2]. Depending on various factors, such as the degree of liver cirrhosis and pretreatment with hepatotoxic chemotherapy, the volume of the FLR should be at least 20-40% of the total liver volume in order to be eligible for surgery (TLV) [3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Correlation Between Sarcopenia and Growth Rate of the Future Liver Remnant After Portal Vein Embolization in Patients with Colorectal Liver Metastases

Schulze-Hagen

Truhn

Duong

et al. 2020

Cardiovasc Intervent Radiol

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Purpose To investigate whether sarcopenia and myosteatosis correlate with the degree of hypertrophy (DH) and kinetic growth rate (KiGR) of the future liver remnant (FLR) in patients with colorectal liver metastases undergoing portal vein embolization (PVE) in preparation for right hepatectomy. Materials and Methods Forty-two patients were included. Total liver volume and FLR volume were measured before and 2-4 weeks after PVE. KiGR of the FLR was calculated. Sarcopenia was assessed using the total psoas muscle volume (PMV), the psoas muscle cross-sectional area (PMCS) and the total skeletal muscle index (L3SMI) at the level of 3rd lumbar vertebra. Degree of myosteatosis was assessed by mean muscle attenuation at L3 (L3MA). Correlations between muscle indices and DH and KiGR were assessed using simple linear regression analyses. Results Mean DH was 8.9 ± 5.7%, and mean KiGR was 3.6 ± 2.3. Mean PMV was 55.56 ± 14.19 cm 3 /m 3 , mean PMCS was 8.76 ± 2.3 cm 2 /m 2 , mean L3SMI was 45.6 ± 9.89 cm 2 /m 2 , and mean L3MA was 27.9 ± 18.6 HU. There was a strong positive correlation between PMV and DH (R = 0.503, p = 0.001) and PMV and KiGR (R = 0.545, p \ 0.001). Furthermore, there was a moderate correlation between PMCS and KiGR (R = 0.389, p = 0.014). L3SMI and L3MA were neither associated with DH (p = 0.390 and p = 0.768, respectively) nor with KiGR (p = 0.188 and p = 0.929, respectively). Conclusion We identified a positive correlation between PMV and PMCS, as markers for sarcopenia, and the KiGR of the FLR after PVE. PMV and PMCS might therefore aid to identify patients who are poor candidates for FLR augmentation using PVE alone. KeywordsPortal vein embolization Á Sarcopenia Á Liver hypertrophy Á FLR Á PVE Abbreviations FLR Future liver remnant PVE Portal vein embolization TLV Total liver volume KiGR Kinetic growth rate DH Degree of hypertrophy PMV Psoas muscle volume PMCS Psoas muscle cross-sectional area at the largest diameter L3SMI Skeletal muscle index at the level of the 3rd lumbar vertebra L3MA Mean muscle attenuation at the level of the 3rd lumbar vertebra

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Preoperative Interventions: Portal Vein Embolization

Mondal¹,

Mukund

2020

Basics of Hepatobiliary Interventions

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Portal Vein Embolization Utilizing N-Butyl Cyanoacrylate for Contralateral Lobe Hypertrophy Prior to Liver Resection: A Systematic Review and Meta-Analysis

Abstract: Level IIa-Systematic review of cohort studies.

Cited by 27 publications

References 29 publications

Safety and outcomes of pre-operative portal vein embolization using N-butyl cyanoacrylate (Glue) in hepatobiliary malignancies: A single center retrospective analysis

Safety and outcomes of pre-operative portal vein embolization using N-butyl cyanoacrylate (Glue) in hepatobiliary malignancies: A single center retrospective analysis

Correlation Between Sarcopenia and Growth Rate of the Future Liver Remnant After Portal Vein Embolization in Patients with Colorectal Liver Metastases

Preoperative Interventions: Portal Vein Embolization

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