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Lookup NU author(s): Steven White
This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).
© 2024 The AuthorsBackground: 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.
Author(s): Smits J, Chau S, James S, Korenblik R, Tschogl M, Arntz P, Bednarsch J, Abreu de Carvalho L, Detry O, Erdmann J, Gruenberger T, Hermie L, Neumann U, Sandstrom P, Sutcliffe R, Denys A, Melloul E, Dewulf M, van der Leij C, Chevallier P, Wigmore S, Newhook T, Vauthey J-N, Memeo R, Dasari BV, Braunwarth E, Aldrighetti L, van Baardewijk L, Barbier L, Binkert C, Bjornsson B, Andorra EC, Arslan B, Baclija I, Bemelmans M, Bent C, de Boer MT, Bokkers RPH, de Boo D, Breen D, Breitenstein S, Bruners P, Cappelli A, Carling U, Casellas i Robert M, Chan B, De Cobelli F, Cha C, Choi J, Crawford M, Croagh D, van Dam R, van Dam R, Deprez F, Diaz-Nieto R, Dili A, Erdmann JI, Font JC, Davis R, Delle M, Fernando R, Fouraschen S, Fretland AA, Fundora Y, Gelabert A, Gerard L, Gobardhan P, Gomez F, Guiliante F, Grochola LF, Grunhagen D, Gimenez JG, Hagendoorn J, Heil J, Heise D, Herrero E, Hess G, Hilal MA, Hoffmann M, Iezzi R, Imani F, Inmutto N, James S, Garcia Borobia FJ, Jovine E, Kalil J, Kingham P, Clarunis OK, Kleeff J, Lopez-Ben S, Macdonald A, Meijerink M, Lapisatepun W, Leclercq W, Lindsay R, Lucidi V, Madoff DC, Martel G, Mehrzad H, Menon K, Metrakos P, Modi S, Moelker A, Montanari N, Moragues JS, Lopez JN, Nguyen J, Peddu P, Primrose J, Damink SO, Qu X, Raptis DA, Ratti F, Ryan S, Ridouani F, Borel Rinkes IHM, Rogan C, Ronellenfitsch U, Serenari M, Salik A, Sallemi C, Martin ES, Sarria L, Schadde E, Serrablo A, Settmacher U, Smits M, Snitzbauer A, Soonawalla Z, Sparrelid E, Spuentrup E, Stavrou G, Tancredi I, Tasse JC, Teichgraber U, Udupa V, Valenti DA, Vass D, Vogl T, Wang X, White S, De Wispelaere J-F, Wohlgemuth W, YU D, Zijlstra I
Publication type: Article
Publication status: Published
Journal: HPB
Year: 2024
Pages: epub ahead of print
Online publication date: 16/07/2024
Acceptance date: 11/07/2024
Date deposited: 30/09/2024
ISSN (print): 1365-182X
ISSN (electronic): 1477-2574
Publisher: Elsevier B.V.
URL: https://doi.org/10.1016/j.hpb.2024.07.407
DOI: 10.1016/j.hpb.2024.07.407
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