Combining Laparoscopic Liver Partitioning and Simultaneous Portohepatic Venous Deprivation for Rapid Liver Hypertrophy

J Vasc Interv Radiol. 2022 May;33(5):525-529. doi: 10.1016/j.jvir.2022.01.018.

Abstract

Future liver remnant (FLR) volume is an important indicator of the risk of posthepatectomy liver failure (PHLF) and limits the feasibility of major hepatectomies. A case series of 5 patients treated with a novel approach is presented. Laparoscopic liver partitioning was combined with subsequent liver venous deprivation (embolization of both the portal and the hepatic veins). Baseline average FLR was 28.8%. All procedures were successfully performed without major complications. Mean 1-, 2- and 4-week hypertrophy of the FLR were 35%, 40.3%, and 46.4%, respectively. Four patients underwent planned surgery after a mean interval of 28 days. Of these, 2 patients achieved sufficient FLR volume and function after 2 weeks and underwent surgery before the 4-week volumetric analysis. One patient did not undergo surgery because of intraoperative diagnosis of peritoneal metastases. No cases of PHLF were observed at 5-day follow-up.

MeSH terms

  • Humans
  • Hypertrophy / complications
  • Hypertrophy / surgery
  • Laparoscopy* / adverse effects
  • Liver Failure* / diagnosis
  • Liver Neoplasms* / complications
  • Liver Neoplasms* / diagnostic imaging
  • Liver Neoplasms* / surgery
  • Portal Vein / diagnostic imaging
  • Portal Vein / surgery