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  • Title: [Effect of liver cirrhosis on percutaneous selective portal vein embolization for primary liver cancer].
    Author: Sun JH, Zhang YL, Nie CH, Li J, Zhou TY, Zhou GH, Chen LM, He JD, Wu J, Shen Y, Zhang M, Wang WL, Zheng SS.
    Journal: Zhonghua Yi Xue Za Zhi; 2013 Dec 24; 93(48):3831-4. PubMed ID: 24548443.
    Abstract:
    OBJECTIVE: To evaluate the clinical value of PVE (portal vein embolism) prior to surgery in primary liver cancer (PLC) patients and the effect of liver cirrhosis on liver lobe hyperplasia after PVE. METHODS: 13 patients with primary liver cancer non-suitable for curative hepatectomy underwent k sequential transcatheter arterial chemoembolization (TACE) (1-3 times) and percutaneous selective portal vein embolization (PVE) when the remnant liver volumes were predicted to be insufficient. All patients were divided into non-cirrhosis (n = 7) and cirrhosis group (n = 6). Left liver remnant volumes were assessed by computed tomography (CT) before and after PVE. Right liver resection was performed when the remnant liver volume was sufficient. RESULTS: All patients underwent TACE treatment was successful. The frequency of TACE was 1-3. PVE was all successfully performed at weeks 2-4 after final TACE, all PVE patients subsequently underwent hepatic lobectomy. Left liver volume increased from (457.0 ± 121.0) cm(3) pre-PVE to (633.6 ± 120.2)cm(3) post-PVE. Hepatic lobe volume increased (44.4 ± 39.7)%. Statistical difference existed in left hepatic lobe volume before and weeks 4-6 after PVE (P = 0.000). The mean volume of left liver, calculated before and 4-6 weeks after PVE, increased from (442.0 ± 96.8) to (652.3 ± 115.8) cm(3) in non-cirrhotic group and from (474.5 ± 152.4) to (611.7 ± 132.3) cm(3) in cirrhotic group. Hepatic lobe volume increased (54.5 ± 50.7)% and (32.7 ± 19.9)% respectively. Statistical differences were both detected in left hepatic lobe volume before and 4-6 weeks after PVE (P = 0.011, P = 0.003). However, no significant inter-group difference existed at Weeks 4-6 weeks (P = 0.295) . Liver function damage was minimal after PVE and no serious complications occurred. CONCLUSION: Sequential transcatheter arterial chemoembolization, TACE and percutaneous selective PVE before surgery may cause remnant liver compensatory hypertrophy and increase the resection rate of primary liver cancer. Liver cirrhosis has no significant effect on liver lobe hyperplasia after PVE.
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