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Dilatation of left portal vein after right portal vein embolization: a simple estimation for growth of future liver remnant.

Authors:
Hyo Jung Park Kyoung Won Kim Sang Hyun Choi Jeongjin Lee Heon-Ju Kwon Jae Hyun Kwon Gi-Won Song Sung-Gyu Lee

J Hepatobiliary Pancreat Sci 2019 Jul 10;26(7):300-309. Epub 2019 Jun 10.

Division of Liver Transplantation and Hepatobiliary Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Background: To evaluate correlation between growth rate of left portal vein (LPV) and future liver remnant (FLR) after right portal vein embolization (PVE), and to design models predicting FLR growth rate and volume using LPV area measurements on computed tomography (CT).

Methods: A total of 134 patients (59.6 ± 10.2 years; 103 men) who underwent right PVE with contrast-enhanced CT before and 3-5 weeks after PVE were retrospectively identified. Kinetic hypertrophy ratio (KHR) and kinetic degree of hypertrophy (KDH) served as growth rate parameters. Correlations between LPV growth rate and FLR growth rate and volume change were evaluated by linear regression analysis. The agreements between actual volumetrically determined growth rates and volume of FLR and those estimated from regression equation using LPV measurements were assessed by Bland-Altman plots.

Results: Growth rates of LPV and FLR correlated significantly (P < 0.001). The mean difference between actual and estimated value was 0.1% for KHR-FLR (actual, 9.5 ± 6.0%; estimated, 9.4 ± 3.8%), 0.0% for KDH-FLR (actual, 3.3 ± 1.4%; estimated, 3.3 ± 0.7%), -3.8 cm for FLR volume (actual, 642.5 ± 167.8 cm ; estimated, 646.4 ± 156.5 cm ), and -0.1% for proportion of FLR volume (actual, 48.7 ± 7.8%; estimated, 48.9 ± 7.8%).

Conclusions: After right PVE, FLR growth rate and volume can be simply estimated from the change in LPV area.

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http://dx.doi.org/10.1002/jhbp.633DOI Listing
July 2019

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