Hepatic hypertrophy and hemodynamics of portal venous flow after percutaneous transhepatic portal embolization

• Published in: BMC surgery Vol. 19; no. 1; p. 23
• Main Authors: Shimada, Shingo, Kamiyama, Toshiya, Yokoo, Hideki, Orimo, Tatsuya, Wakayama, Kenji, Nagatsu, Akihisa, Kakisaka, Tatsuhiko, Kamachi, Hirofumi, Abo, Daisuke, Sakuhara, Yusuke, Taketomi, Akinobu
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 18-02-2019; BioMed Central; BMC
• Subjects: Bile; Correlation analysis; Diagnostic imaging; Embolization; Gastroenterology; Hemodynamics; Hepatectomy; Hepatic hypertrophy; Hypertrophy; Liver; Liver cancer; Liver diseases; Medical imaging; Multivariate analysis; Patients; Percutaneous transhepatic portal embolization; Portal venous flow; Povidone; Tumors; Ultrasonic imaging; Ultrasonic testing; Ultrasound; Ultrasound imaging; Veins & arteries; Work stations; United States > US; Japan; Hepatic hypertrophy; Percutaneous transhepatic portal embolization; Portal venous flow
• ISSN: 1471-2482; 1471-2482
• DOI: 10.1186/s12893-019-0486-8

Percutaneous transhepatic portal embolization (PTPE) is useful for safe major hepatectomy. This study investigated the correlation between hepatic hypertrophy and hemodynamics of portal venous flow by ultrasound sonography after PTPE.
We analyzed 58 patients with PTPE, excluding those who underwent recanalization (n = 10). Using CT volumetry results 2 weeks after PTPE, the patients were stratified into a considerable hypertrophy group (CH; n = 15) with an increase rate of remnant liver volume (IR-RLV) ≥ 40% and a minimal hypertrophy group (MH; n = 33) with an IR-RLV < 40%. We investigated the hemodynamics of portal venous flow after PTPE and the favorable factors for hepatic hypertrophy.
Univariate and multivariate analysis identified the indocyanine green retention rate at 15 min (ICGR15) and increase rate of portal venous flow volume (IR-pFV) at the non-embolized lobe on day 3 after PTPE as independent favorable factors of IR-RLV. Patients with IR-pFV on day 3 after PTPE ≥100% and ICGR15 ≤ 15% (n = 13) exhibited significantly increased IR-RLV compared with others (n = 35).
Cases with high IR-pFV on day 3 after PTPE exhibited better hepatic hypertrophy. Preserved liver function and increased portal venous flow on day 3 were important.