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Percutaneous radiofrequency‐assisted liver partition versus portal vein embolization before hepatectomy for perihilar cholangiocarcinoma
- Source :
- BJS Open, BJS Open, Vol 4, Iss 1, Pp 101-108 (2020)
- Publication Year :
- 2019
- Publisher :
- John Wiley & Sons, Ltd, 2019.
-
Abstract
- Background Percutaneous radiofrequency‐assisted liver partition with portal vein embolization in staged liver resection (PRALPPS) represents an alternative to portal vein embolization (PVE) followed by major liver resection in patients with perihilar cholangiocarcinoma. Methods This was an observational case–control study. Both procedures were applied in patients with a future liver remnant (FLR) volume of less than 40 per cent. The main end points of the study were short‐term morbidity and mortality for the two procedures. The study also compared the efficacy of the preresection phases estimated by kinetic growth rate (KGR), time interval and degree of hypertrophy of the FLR. Results The first phase (preresection) was completed in 11 and 18 patients, and the second phase (resection) in nine and 14 patients, in the PRALPPS and PVE groups respectively. Major morbidity after the first stage did not differ between the groups. There were no differences in blood loss, severe morbidity or liver failure rate after the second stage, with no deaths. The mean KGR of the FLR after the preresection phase for PRALPPS was 3·8 (0·6–9·8) per cent/day, and that after PVE was 1·8 (0–6·7) per cent/day (P = 0·037). The mean time interval for FLR hypertrophy in the PRALPPS and PVE groups was 15 (6–29) and 20 (8–35) days respectively (P = 0·039). Conclusion Short‐term outcomes were similar for PRALPPS and PVE in terms of safety. Remnant hypertrophy was achieved more rapidly by PRALPPS.<br />Percutaneous radiofrequency‐assisted liver partition with portal vein embolization in staged liver resection (PRALPPS), modIfied ALPPS with reduced surgical trauma on the first stage, was used in 11 patients with perihilar cholangiocarcinoma. PRALPPS did not differ from portal vein embolization (PVE) in terms of morbidity or mortality. The kinetic growth rate and mean time interval for future liver remnant hypertrophy in the PRALPPS group were significantly better than those in the PVE group. Similar complication rates and outcomes
- Subjects :
- Adult
Male
medicine.medical_specialty
Percutaneous
medicine.medical_treatment
lcsh:Surgery
030230 surgery
Muscle hypertrophy
03 medical and health sciences
0302 clinical medicine
medicine
Hepatectomy
Humans
Stage (cooking)
Perihilar Cholangiocarcinoma
Aged
business.industry
Surrogate endpoint
Portal Vein
Liver failure
General Medicine
lcsh:RD1-811
Original Articles
Middle Aged
Embolization, Therapeutic
Surgery
Survival Rate
Treatment Outcome
Bile Duct Neoplasms
Liver
030220 oncology & carcinogenesis
HPB
Case-Control Studies
Portal vein embolization
Original Article
Female
business
Klatskin Tumor
Subjects
Details
- Language :
- English
- ISSN :
- 24749842
- Volume :
- 4
- Issue :
- 1
- Database :
- OpenAIRE
- Journal :
- BJS Open
- Accession number :
- edsair.doi.dedup.....b37eca34b452a159ca79cd51ed6b771b