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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Dynamic Evaluation of Liver Volume and Function in Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy
Journal of Gastrointestinal Surgery, Volume 21, No. 6, Year 2017
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Description
Background: Despite a fast and potent growth of the future liver remnant (FLR), patients operated with associating liver partition and portal vein ligation for staged hepatectomy (ALPPS) are at risk of developing posthepatectomy liver failure. In this study, the relation between liver volume and function in ALPPS was studied using a multimodal assessment. Methods: Nine patients with colorectal liver metastases treated with neoadjuvant chemotherapy and operated with ALPPS were studied with hepatobiliary scintigraphy, computed tomography, indocyanine green clearance test, and serum liver function tests. A comparison between liver volume and function was conducted. Results: The preoperative FLR volume of 19.5% underestimated the preoperative FLR function of 25.3% (p = 0.011). The increase in FLR volume exceeded the increase in function at day 6 after stage 1 (FLR volume increase 56.7% versus FLR function increase 28.2%, p = 0.021), meaning that the increase in function was 50% of the increase in volume. After stage 2, functional increase exceeded the volume increase, resulting in similar values 28 days after stage 2. Conclusions: In the inter-stage period of ALPPS, the high volume increase is not paralleled by a corresponding functional increase. This may in part explain the high morbidity and mortality rates associated with ALPPS. Functional assessment of the FLR is advised. © 2017, The Author(s).
Authors & Co-Authors
Sparrelid, Ernesto
Sweden, Stockholm
Karolinska Institutet
Jonas, Eduard G.
Sweden, Stockholm
Karolinska Institutet
Tzortzakakis, Antonios
Sweden, Stockholm
Karolinska Institutet
Brismar, Torkel B.
Sweden, Stockholm
Karolinska Institutet
Axelsson, Rimma
Sweden, Stockholm
Karolinska Institutet
Isaksson, Bengt
Sweden, Stockholm
Karolinska Institutet
Statistics
Citations: 47
Authors: 6
Affiliations: 2
Identifiers
Doi:
10.1007/s11605-017-3389-y
ISSN:
1091255X
Research Areas
Cancer
Study Design
Phenomenological Study