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Role of liver augmentation prior to hepatic resection - a survey on standards, procedures, and indications in Germany, Switzerland, and Austria.
Yilmaz, Elif; Torsello, Giovanni F; Hosseini, Ali Seif Amir; Zygmunt, Anne-Christine; Lorf, Thomas; Keck, Jan; Schild-Suhren, Stina; Wellge, Björn; Oberhuber, Rupert; Kollmar, Otto; Ghadimi, Michael; Bösch, Florian.
Afiliación
  • Yilmaz E; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Torsello GF; Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany.
  • Hosseini ASA; Department of Diagnostic and Interventional Radiology, University Medical Center Göttingen, Göttingen, Germany.
  • Zygmunt AC; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Lorf T; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Keck J; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Schild-Suhren S; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Wellge B; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Oberhuber R; Department of Visceral, Transplant and Thoracic Surgery, Center for Operative Medicine, Medical University of Innsbruck, Innsbruck, Austria.
  • Kollmar O; Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital, Basel, Switzerland.
  • Ghadimi M; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany.
  • Bösch F; Department of General, Visceral, and Pediatric Surgery, University Medical Center Göttingen (UMG), Robert-Koch-Straße 40, 37075, Göttingen, Germany. florian.boesch@med.uni-goettingen.de.
Langenbecks Arch Surg ; 409(1): 228, 2024 Jul 27.
Article en En | MEDLINE | ID: mdl-39066906
ABSTRACT

PURPOSE:

For primary and secondary liver tumors oncological resection remains a chance of cure. Augmentation of functional liver tissue may be necessary to preserve sufficient future liver remnant (FLR). Clinical decision-making on liver augmentation techniques and indications may differ internationally. Thus, this study aims to identify standards of liver augmentation in hepato-pancreatico-biliary (HPB) centers in Germany, Switzerland, and Austria.

METHODS:

Using a web-based survey, 48 hospitals in Germany, Switzerland, and Austria were invited to report their surgical indication, standard procedures, and results of liver augmentation.

RESULTS:

Forty (83.3%) of the hospitals invited participated. Most of the hospitals were certified liver centers (55%), performing complex surgeries such as liver transplantation (57.5%) and ALPPS (80%). The standard liver augmentation technique in all countries was portal vein embolization (PVE; 56%), followed by ALPPS (32.1%) in Germany or PVE with hepatic vein embolization (33.3%) in Switzerland and Austria. Standard procedure for liver augmentation did not correlate with certification as liver center, performance of liver transplantation or ALPPS. Surgical indication for PVE varied depending on tumor entity. Most hospitals rated the importance of PVE before resection of cholangiocarcinoma or colorectal metastases as high, while PVE for hepatocellular carcinoma was rated as low.

CONCLUSION:

The survey gives an overview of the clinical routine in HPB centers in Germany, Austria, and Switzerland. PVE seems to dominate as standard technique to increase the FLR. However, there is a variety in the main indication for liver augmentation. Further studies are necessary evaluating the differing PVE techniques for liver augmentation.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatectomía / Neoplasias Hepáticas Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Langenbecks Arch Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania
Texto completo
Añadir a Mi BVS
Imprimir
XML
PubMed Links
Buscar en Google

Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Hepatectomía / Neoplasias Hepáticas Límite: Humans País/Región como asunto: Europa Idioma: En Revista: Langenbecks Arch Surg Año: 2024 Tipo del documento: Article País de afiliación: Alemania Pais de publicación: Alemania