Late results of embolization of a portal hepatic vein branches in patients, suffering extended hepatic tumors

Keywords: hepatic tumor; hepatic resection; еmbolization of portal vein.

Abstract

Objective. To analyze late results of preoperative  embolization of the portal hepatic vein branches (EPHVB) in patients, suffering extended hepatic tumors and extremely border-like small calculated residual hepatic volume(CRHV).

Маterials and methods. From 2004 to 2014 yr the extended hepatic resection (HER) was performed in 285 patients, to whom EPHVB was applied (the main group), аnd in 353 patients as well, but without endovascular preparation (control group). In both groups dynamics of laboratory indices, structure of complications and lethality, late survival were studied.

Results. In the main group a trustworthily lower rate of an acute hepatic insufficiency and connected with a lower postoperative lethality - accordingly 2.3 and 4.6%, comparing with a control group - 9.3 and 8.8%, were suggested. The laboratory data dynamics have witnessed a lesser intensiveness of postoperative hepatocytolysis and lesser degree of the hepatic synthetic function lowering in the main group, what have confirmed a better functional adaptation of hepatic residual in patients, to whom preoperative EPHVB was applied.

Conclusion. Preoperative EPHVB permits to lower the postoperative complications and lethality rate in patients, suffering hepatic tumors, due to better functional adaptation of hepatic residual.

Author Biographies

O. G. Kotenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Oleg Kotenko, MD, PhD
Head of the Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
kog1999@gmail.com;
http://orcid.org/0000-0001-8264-7374.

V. A. Kondratiuk, Shalimov National Institute of Surgery and Transplantology, Kyiv

Vadym Kondratiuk, PhD
senior researcher Department of Endovascular Surgery
Shalimov National Institute of Surgery and Transplantology,
Address: 30 Heroiv Sevastopolya Str., 03680, Kyiv, Ukraine,
tel.: +38 (044)4542079
vkondr@gmail.com
ORCHID: http://orcid.org/0000-0002-2506-5009

O. O. Korshak, Shalimov National Institute of Surgery and Transplantology, Kyiv

Oleksandr Korshak transplant surgeon
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
akorshak@ukr.net
orcid.org/0000-0002-2625-8320

D. O. Fedorov, Shalimov National Institute of Surgery and Transplantology, Kyiv

Denis Fedorov - PhD, Senior Researcher,
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
D.a.fedorov@gmail.com;
orcid.org/0000-0002-8231-6943.

O. V. Hrynenko, Shalimov National Institute of Surgery and Transplantology, Kyiv

Oleksandr Hrynenko - transplant surgeon, researcher
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
grinenkoalex@gmail.com;
orcid.org/0000-0003-3535-8232.

A. V. Gusev, Shalimov National Institute of Surgery and Transplantology, Kyiv

Andrii Gusev - PhD, Senior Researcher,
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
portalschik74@mail.ru;
orcid.org/0000-0003-0146-4652

O. O. Popov, Shalimov National Institute of Surgery and Transplantology, Kyiv

Oleksii Popov - transplant surgeon, researcher
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
popovalexey@gmail.com;
orcid.org/0000-0003-0333-8473.

M. S. Grygorian, Shalimov National Institute of Surgery and Transplantology, Kyiv

Marat Grygorian - transplant surgeon
Department of Transplantation and Surgery of the Liver,
A.A.Shalimov National Institute of Surgery and Transplantology;
30, Heroiv Sevastopolya str.,Kyiv, Ukraine, 03680
+38(044) 4971374,
grigmarat78@gmail.com;
orcid.org/0000-0002-2579-9440.

References

1. Beppu T, Okabe H, Okuda K, Eguchi S, Kitahara K, Taniai N, et al. Portal Vein Embolization Followed by Right-Side Hemihepatectomy for Hepatocellular Carcinoma Patients: A Japanese Multi-Institutional Study. J Am Coll Surg. 2016 Jun;222(6):1138-48. doi: 10.1016/j.jamcollsurg.2016.03.023.
2. Kinoshita H, Sakai K, Hirohashi K, Igawa S, Yamasaki O, Kubo S. Preoperative portal vein embolization for hepatocellular carcinoma. World J Surg. 1986;10:803-8. doi: 10.4254/wjh.v8.i9.439
3. Seo DD, Lee HC, Jang MK, Min HJ, Kim KM, Lim YS, et al. Preoperative portal vein embolization and surgical resection in patients with hepatocellular carcinoma and small future liver remnant volume: comparison with transarterial chemoembolization. Ann Surg Oncol. 2007 Dec;14(12):3501-9. doi: 10.1245/s10434-007-9553-y.
4. Yamashita S, Hasegawa K, Takahashi M, Inoue Y, Sakamoto Y, Aoki T, et al. One-stage hepatectomy following portal vein embolization for colorectal liver metastasis. World J Surg. 2013 Mar;37(3):622-8. doi: 10.1007/s00268-012-1861-0
5. Yamashita S, Sakamoto Y, Yamamoto S, Takemura N, Omichi K, Shinkawa H, et al. Efficacy of Preoperative Portal Vein Embolization Among Patients with Hepatocellular Carcinoma, Biliary Tract Cancer, and Colorectal Liver Metastases: A Comparative Study Based on Single-Center Experience of 319 Cases. Ann Surg Oncol. 2017 Jun;24(6):1557-68. doi: 10.1245/s10434-017-5800-z.
6. Okabe H, Beppu T, Ishiko T, Masuda T, Hayashi H, Otao R, et al. Preoperative portal vein embolization (PVE) for patients with hepatocellular carcinoma can improve resectability and may improve disease-free survival. J Surg Oncol. 2011 Nov 1;104(6):641-6. doi: 10.1002/jso.21928.
Published
2018-07-26
Section
General Problems of Surgery

Most read articles by the same author(s)