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Discrepancy between volume and functional recovery in early phase liver regeneration following extended hepatectomy with extrahepatic bile duct resection
Author(s) -
Maeda Takashi,
Yokoyama Yukihiro,
Ebata Tomoki,
Igami Tsuyoshi,
Mizuno Takashi,
Yamaguchi Junpei,
Onoe Shunsuke,
Ando Masahiko,
Nagino Masato
Publication year - 2019
Publication title -
hepatology research
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.123
H-Index - 75
eISSN - 1872-034X
pISSN - 1386-6346
DOI - 10.1111/hepr.13378
Subject(s) - hepatectomy , medicine , liver regeneration , radiology , resection , computed tomography , surgery , biology , regeneration (biology) , microbiology and biotechnology
Aim To elucidate the clinical factors having an impact on liver regeneration rate following preoperative portal vein embolization (PVE) and subsequent extended hepatectomy. The correlation between liver volume and functional recovery after extended hepatectomy was also investigated. Methods Records of patients who underwent extended hepatectomy with extrahepatic bile duct resection following PVE for perihilar cholangiocarcinoma were reviewed retrospectively with attention to liver regeneration. All patients underwent computed tomography before PVE, after PVE (immediately before surgery), and on postoperative day (POD) 7. The kinetic growth rate (KGR) was calculated as the percent increase in liver volume relative to the future liver remnant volume per day after PVE (KGR PVE ) and after POD 7 (KGR POD7 ) using the computed tomography images before PVE, after PVE, and on POD 7. Results In the 289 study patients, the median of KGR PVE was 1.35%/day whereas that of KGR POD7 was 5.56%/day. The extent of liver resection had the greatest impact on both KGR PVE and KGR POD7 and the impacts of other factors were less. There was a significant negative correlation between KGR PVE and KGR POD7 ( P = 0.002). No correlations were observed between KGR PVE or KGR POD7 and serum total bilirubin and prothrombin time – international normalized ratio on POD 7, nor in the incidence of liver failure after surgery. Conclusions Early phase liver regeneration after extended hepatectomy was largely influenced by the extent of liver resection and showed no correlation with the indices of liver failure. There was a discrepancy between volume and functional recovery in early phase liver regeneration.