Augmenting the future liver remnant prior to major hepatectomy: A review of options on the menu Review


Authors: Wong, P.; Vien, P.; Kessler, J.; Lafaro, K.; Wei, A.; Melstrom, L. G.
Review Title: Augmenting the future liver remnant prior to major hepatectomy: A review of options on the menu
Abstract: The optimization of the future liver remnant (FLR) is paramount in improving outcomes for patients undergoing liver surgery, as post-hepatectomy liver failure remains a major source of postoperative morbidity and mortality. A wide collection of techniques has been introduced with the goal of augmenting the FLR prior to hepatectomy for primary and secondary liver malignancies, and these modalities include portal vein embolization (PVE), portal vein ligation (PVL), liver venous deprivation (LVD), associating liver partition and portal vein ligation for staged hepatectomy (ALPPS), and radioembolization (e.g., Y-90). There are advantages and drawbacks for each of these methods regarding the capacity for FLR hypertrophy sufficient for resection, perioperative morbidity/mortality, and long-term oncologic outcomes. In the context of technical variations when performing the procedures, there have been comparative studies between the various methods of FLR optimization, however, not many in a controlled fashion. Results from ongoing and future randomized controlled trials will help refine these techniques, directly compare outcomes, and personalize strategies based on patient-specific factors. In this review, the benefits of the various FLR augmentation approaches are summarized and the current literature and trials are reviewed. © The Author(s) 2025.
Keywords: adult; review; randomized controlled trial; retrospective study; liver failure; surgery; liver surgery; hepatectomy; liver cancer; drug therapy; therapy; complication; yttrium 90; portal vein embolization; radioembolization; human; liver vein; future liver remnant; liver venous deprivation; associating liver partition and portal vein ligation for staged hepatectomy; portal vein ligation; dextran 40
Journal Title: Annals of Surgical Oncology
Volume: 32
Issue: 8
ISSN: 1068-9265
Publisher: Springer  
Publication status: Published
Date Published: 2025-08-01
Online Publication Date: 2025-06-08
Start Page: 5694
End Page: 5704
Language: English
DOI: 10.1245/s10434-025-17607-z
PROVIDER: scopus
PMCID: PMC12222409
PUBMED: 40483651
DOI/URL:
Notes: Review -- Source: Scopus
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  1. Alice Chia-Chi Wei
    202 Wei