• Br J Surg · Jul 2021

    Randomized Controlled Trial Multicenter Study

    Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.

    • J Heil, R Korenblik, F Heid, W O Bechstein, M Bemelmans, C Binkert, B Björnsson, S Breitenstein, O Detry, A Dili, R F Dondelinger, L Gerard, T Giménez-Maurel, B Guiu, D Heise, M Hertl, J A Kalil, J J Klein, A Lakoma, U P Neumann, B Olij, S G Pappas, P Sandström, A Schnitzbauer, A Serrablo, J Tasse, C Van der Leij, P Metrakos, R Van Dam, and E Schadde.
    • Institute of Physiology, University of Zurich, Zurich, Switzerland.
    • Br J Surg. 2021 Jul 23; 108 (7): 834-842.

    BackgroundThe extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability.MethodsAll centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis.ResultsIn total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders.ConclusionPVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email: journals.permissions@oup.com.

      Pubmed     Full text   Copy Citation     Plaintext  

      Add institutional full text...

    Notes

     
    Knowledge, pearl, summary or comment to share?
    300 characters remaining
    help        
    You can also include formatting, links, images and footnotes in your notes
    • Simple formatting can be added to notes, such as *italics*, _underline_ or **bold**.
    • Superscript can be denoted by <sup>text</sup> and subscript <sub>text</sub>.
    • Numbered or bulleted lists can be created using either numbered lines 1. 2. 3., hyphens - or asterisks *.
    • Links can be included with: [my link to pubmed](http://pubmed.com)
    • Images can be included with: ![alt text](https://bestmedicaljournal.com/study_graph.jpg "Image Title Text")
    • For footnotes use [^1](This is a footnote.) inline.
    • Or use an inline reference [^1] to refer to a longer footnote elseweher in the document [^1]: This is a long footnote..

    hide…