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Intrahepatic left to right portoportal venous collateral vascular formation in patients undergoing right portal vein ligation.
van Lienden, K P; Hoekstra, L T; Bennink, R J; van Gulik, T M.
Afiliación
  • van Lienden KP; Department of Interventional Radiology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands. k.p.vanlienden@amc.uva.nl.
  • Hoekstra LT; Department of Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
  • Bennink RJ; Department of Nuclear Medicine, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
  • van Gulik TM; Department of Surgery, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
Cardiovasc Intervent Radiol ; 36(6): 1572-1579, 2013 Dec.
Article en En | MEDLINE | ID: mdl-23483283
PURPOSE: We investigated intrahepatic vascular changes in patients undergoing right portal vein ligation (PVL) or portal vein embolization (PVE) in conjunction with the ensuing hypertrophic response and function of the left liver lobe. METHODS: Between December 2008 and October 2011, 7 patients underwent right PVL and 14 patients PVE. Computed tomographic (CT) volumetry to assess future remnant liver (FRL) and functional hepatobiliary scintigraphy were performed in all patients before and 3 weeks after portal vein occlusion. In 18 patients an intraoperative portography was performed to assess perfusion through the occluded portal branches. RESULTS: In all patients after initially successful PVL, reperfused portal veins were observed on CT scan 3 weeks after portal occlusion. This was confirmed in all cases during intraoperative portography. Intrahepatic portoportal collaterals were identified in all patients in the PVL group and in one patient in the PVE group. In all other PVE patients, complete occlusion of the embolized portal branches was observed on CT scan and on intraoperative portography. The median increase of FRL volume after PVE was 41.6 % (range 10-305 %), and after PVL was only 8.1 % (range 0-102 %) (p = 0.179). There were no differences in FRL function between both groups. CONCLUSION: Preoperative PVE and PVL are both methods to induce hypertrophy of the FRL in anticipation of major liver resection. Compared to PVE, PVL seems less efficient in inducing hypertrophy of the nonoccluded left lobe. This could be caused by the formation of intrahepatic portoportal neocollateral vessels, through which the ligated portal branches are reperfused within 3 weeks.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vena Porta / Circulación Colateral / Hepatomegalia / Circulación Hepática Tipo de estudio: Etiology_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Intervent Radiol Año: 2013 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Vena Porta / Circulación Colateral / Hepatomegalia / Circulación Hepática Tipo de estudio: Etiology_studies Límite: Female / Humans / Male / Middle aged Idioma: En Revista: Cardiovasc Intervent Radiol Año: 2013 Tipo del documento: Article País de afiliación: Países Bajos Pais de publicación: Estados Unidos