IMPACT OF LIVER FIBROSIS ON RESULTS OF LIVER HYPERTROPHY AFTER LIVER VENOUS DEPRIVATION

Văn Sỹ Thân, Thanh Dũng Lê, Minh Thông Phạm

Main Article Content

Abstract

Liver venous deprivation (LVD) is recently used to increase future liver remnant volume before major hepatectomy in treating hepatocellular carcinoma (HCC). HCC patients often have underlying liver disease and cirrhosis, which may affect the degree of liver hypertrophy after LVD. This report aims to evaluate the impact of liver fibrosis on the effectiveness of liver hypertrophy after LVD in HCC patients. A retrospective study was conducted on 44 HCC patients who underwent successful hepatectomy after LVD. Based on postoperative histopathological results, these patients were divided into non-fibrosis group F1-2 and fibrosis group F3-4. There was a significant change in FLR volume for all patients before and 3 weeks after LVD (p < 0.001). LVD resulted in a significantly higher rate of liver hypertrophy in the F1-2 fibrosis group than in the F3-4 group (61% vs. 47%, p = 0.016). LVD before major hepatectomy may induce significant FLR hypertrophy and increase the resectability for HCC patients. The F1-2 fibrosis group achieved a statistically significantly higher rate of liver hypertrophy than the F3-4 fibrosis group.

Article Details

References

1. Schreckenbach T, Liese J, Bechstein WO, Moench C. Posthepatectomy liver failure. Dig Surg. 2012;29(1):79-85.
2. Van Lienden KP, Van Den Esschert JW, De Graaf W, et al. Portal vein embolization before liver resection: a systematic review. Cardiovasc Intervent Radiol. 2013;36(1):25-34.
3. Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surg Nutr. 2020;9(5):564.
4. Le Roy B, Gallon A, Cauchy F, et al. Combined biembolization induces higher hypertrophy than portal vein embolization before major liver resection. HPB. 2020;22(2):298-305.
5. Lê Thanh Dũng (2018). Nghiên cứu áp dụng và đánh giá hiệu quả của phương pháp nút nhánh tĩnh mạch cửa gây phì đại gan trước phẫu thuật cắt gan. Luận án Tiến sĩ Y học, Trường Đại học Y Hà Nội.
6. Sun JH, Zhang YL, Nie CH, et al. Effects of liver cirrhosis on portal vein embolization prior to right hepatectomy in patients with primary liver cancer. Oncol Lett. 2018;15(2):1411-1416.
7. Guiu B, Herrero A, Panaro F. Liver venous deprivation: a bright future for liver metastases—but what about hepatocellular carcinoma? Hepatobiliary Surg Nutr. 2021;10(2):270.
8. Thân Văn Sỹ, Lê Thanh Dũng, Phạm Minh Thông. Kết quả của phương pháp nút tĩnh mạch cửa và tĩnh mạch gan sử dụng đường tiếp cận tĩnh mạch gan qua tĩnh mạch cảnh trong so với đường tiếp cận qua nhu mô gan. Tạp chí Y học Việt Nam. 2024;535(1B).
9. Thân Văn Sỹ, Lê Thanh Dũng, Cao Mạnh Thấu, và cộng sự. Kết quả tăng thể tích gan sau nút tĩnh mạch cửa và tĩnh mạch gan trước phẫu thuật ở nhóm bệnh nhân ung thư biểu mô tế bào gan. Tạp Chí Nghiên Cứu Học. 2023;170(9):195-204.
10. Laurent C, Fernandez B, Marichez A, et al. Radiological simultaneous portohepatic vein embolization (RASPE) before major hepatectomy: a better way to optimize liver hypertrophy compared to portal vein embolization. Ann Surg. 2020;272(2):199-205.