Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma Journal Article
| Authors: | Smits, J.; Chau, S.; James, S.; Korenblik, R.; Tschögl, M.; Arntz, P.; Bednarsch, J.; Abreu de Carvalho, L.; Detry, O.; Erdmann, J.; Gruenberger, T.; Hermie, L.; Neumann, U.; Sandström, P.; Sutcliffe, R.; Denys, A.; Melloul, E.; Dewulf, M.; van der Leij, C.; van Dam, R. M.; for the EuroLVD and DRAGON Trials Collaborative |
| Contributors: | Kingham, P.; Santos Martin, E.; Ridouani, F. |
| Article Title: | Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma |
| Abstract: | Background: Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates. Methods: In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023. Results: Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%. Conclusion: PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection. © 2024 The Authors |
| Keywords: | adult; clinical article; aged; disease classification; lymph node dissection; retrospective study; multicenter study; blood transfusion; hepatectomy; tumor growth; observational study; bilirubin blood level; disease exacerbation; klatskin tumor; perioperative care; volumetry; clinical outcome; portal vein embolization; arterial embolization; cholangitis; human; male; female; article; ecog performance status; hepatic vein embolization |
| Journal Title: | HPB |
| Volume: | 26 |
| Issue: | 12 |
| ISSN: | 1365-182X |
| Publisher: | Elsevier Science, Inc. |
| Date Published: | 2024-12-01 |
| Start Page: | 1458 |
| End Page: | 1466 |
| Language: | English |
| DOI: | 10.1016/j.hpb.2024.07.407 |
| PUBMED: | 39277435 |
| PROVIDER: | scopus |
| DOI/URL: | |
| Notes: | Source: Scopus |
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