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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.S. Kim  ;  J.B. Chung  ;  W.J. Lee  ;  J.S. Choi  ;  Y.N. Park  ;  S.W. Park  ;  K.H. Lee 
Citation
 European Journal of Surgical Oncology, Vol.37(3) : 237-244, 2011 
Journal Title
 European Journal of Surgical Oncology 
ISSN
 0748-7983 
Issue Date
2011
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.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/93125
DOI
10.1016/j.ejso.2010.12.010
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Pathology (병리학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Surgery (외과학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
Yonsei Authors
김경식(Kim, Kyung Sik) ; 박승우(Park, Seung Woo) ; 박영년(Park, Young Nyun) ; 이광훈(Lee, Kwang Hun) ; 이우정(Lee, Woo Jung) ; 정재복(Chung, Jae Bock) ; 최진섭(Choi, Jin Sub) ; 홍영기(Hong, Young Ki)
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Full Text
http://www.sciencedirect.com/science/article/pii/S0748798310006098
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