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The efficacy of portal vein embolization prior to right extended hemihepatectomy for hilar cholangiocellular carcinoma: a retrospective cohort study.

Authors
 Y.K. Hong  ;  S.B. Choi  ;  K.H. Lee  ;  S.W. Park  ;  Y.N. Park  ;  J.S. Choi  ;  W.J. Lee  ;  J.B. Chung  ;  K.S. Kim 
Citation
 EJSO, Vol.37(3) : 237-244, 2011 
Journal Title
EJSO
ISSN
 0748-7983 
Issue Date
2011
MeSH
Adult ; Aged ; Bile Duct Neoplasms/mortality ; Bile Duct Neoplasms/pathology ; Bile Duct Neoplasms/therapy* ; Bile Ducts, Intrahepatic* ; Chi-Square Distribution ; Cholangiocarcinoma/mortality ; Cholangiocarcinoma/pathology ; Cholangiocarcinoma/therapy* ; Combined Modality Therapy ; Embolization, Therapeutic/methods* ; Female ; Hepatectomy/methods* ; Hospital Mortality ; Humans ; Male ; Middle Aged ; Portal Vein* ; Statistics, Nonparametric ; Treatment Outcome
Keywords
Portal vein embolization ; Hilar cholangiocellular carcinoma ; Extended hemihepatectomy
Abstract
BACKGROUND/PURPOSE: Preoperative portal vein embolization was introduced to minimize complications after extended hepatectomy. This retrospective cohort study was conducted to compare outcomes with and without portal vein embolization before hepatectomy for hilar cholangiocellular carcinoma.

METHODS: This study was conducted with 35 patients who underwent right extended hemihepatectomy for hilar cholangiocellular carcinoma from 2001 to 2008. Preoperative portal vein embolization was performed in 14 patients (embolization group) and not performed in 21 patients (non-embolization group).

RESULTS: The groups did not differ in terms of sex, age, operative time, transfusion, postoperative serum bilirubin level, prothrombin time, and length of intensive care unit (ICU) stay. Although blood loss was higher in the embolization group than in the non-embolization group (P = .009), no major complications were observed between embolization and resection. At presentation, future liver remnant was smaller in the embolization group (19.8%, range 16-35%) than in non-embolization group (28.3%, 15-47%; P = .001). After embolization, the volume of the future liver remnant increased significantly to 27.2% (range, 23-42%; P = .001). Future liver remnants just before operation were similar in both groups (P > .99). There was no significant difference in terms of the rate of morbidity and in-hospital mortality. No statistically significant differences were observed in disease-free survival (P = .52) and overall survival (P = .30).

CONCLUSIONS: Portal vein embolizations do not increase the rate of morbidity, in-hospital mortality, local recurrence and system metastasis. Therefore it can be considered safe and effective for patients with small future liver remnants. Embolization can lessen postoperative liver failure and widen the indication of the surgical resection, especially in patients with marginal future liver remnants.
Full Text
http://www.sciencedirect.com/science/article/pii/S0748798310006098
DOI
10.1016/j.ejso.2010.12.010
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Kyung Sik(김경식) ORCID logo https://orcid.org/0000-0001-9498-284X
Park, Seung Woo(박승우) ORCID logo https://orcid.org/0000-0001-8230-964X
Park, Young Nyun(박영년) ORCID logo https://orcid.org/0000-0003-0357-7967
Lee, Kwang Hun(이광훈)
Lee, Woo Jung(이우정) ORCID logo https://orcid.org/0000-0001-9273-261X
Chung, Jae Bock(정재복)
Choi, Jin Sub(최진섭)
Hong, Young Ki(홍영기)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93125
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