Assessment of Segmentary Hypertrophy of Future Remnant Liver after Liver Venous Deprivation: A Single-Center Study

Author:

Al Taweel Bader1,Cassese Gianluca2,Khayat Salah13,Chazal Maurice4,Navarro Francis1,Guiu Boris5,Panaro Fabrizio16

Affiliation:

1. Department of Digestive Surgery and Liver Transplantation, Montpellier University Hospital, 34090 Montpellier, France

2. Department of Clinical Medicine and Surgery, Division of Minimally Invasive and Robotic HPB Surgery and Transplantation Service, University of Naples “Federico II”, 80131 Naples, Italy

3. Department of Visceral and Digestive Surgery, Centre Hospitalier de Perpignan, 66000 Perpignan, France

4. Department of General and Visceral Surgery, Centre Hospitalier Princesse Grace, 98000 Monaco, Monaco

5. Department of Diagnostic and Interventional Radiology, Montpellier University Hospital, 34090 Montpellier, France

6. Department of Surgery, Università del Piemonte Orientale, 15121 Alessandria, Italy

Abstract

Background: Liver venous deprivation (LVD) is a recent radiological technique that has shown promising results on Future Remnant Liver (FRL) hypertrophy. The aim of this retrospective study is to compare the segmentary hypertrophy of the FRL after LVD and after portal vein embolization (PVE). Methods: Patients undergoing PVE or LVD between April 2015 and April 2020 were included. The segmentary volumes (seg 4, seg2+3 and seg1) were assessed before and after the radiological procedure. Results: Forty-four patients were included: 26 undergoing PVE, 10 LVD and 8 eLVD. Volume gain of both segment 1 and segments 2+3 was significantly higher after LVD and eLVD than after PVE (segment 1: 27.33 ± 35.37 after PVE vs. 38.73% ± 13.47 after LVD and 79.13% ± 41.23 after eLVD, p = 0.0080; segments 2+3: 40.73% ± 40.53 after PVE vs. 45.02% ± 21.53 after LVD and 85.49% ± 45.51 after eLVD, p = 0.0137), while this was not true for segment 4. FRL hypertrophy was confirmed to be higher after LVD and eLVD than after PVE (33.53% ± 21.22 vs. 68.63% ± 42.03 vs. 28.11% ± 28.33, respectively, p = 0.0280). Conclusions: LVD and eLVD may induce greater hypertrophy of segment 1 and segments 2+3 when compared to PVE.

Publisher

MDPI AG

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