First results from the international registry on liver venous deprivation (EuroLVD).

IF 2.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Hpb Pub Date : 2025-04-28 DOI:10.1016/j.hpb.2025.02.017

Gaëtan-Romain Joliat, Patrick Chevallier, Stephen Wigmore, David Martin, Ismail Labgaa, Emilie Uldry, Nermin Halkic, Timothy Newhook, Antony Haddad, Jean-Nicolas Vauthey, Riccardo Memeo, Bobby V M Dasari, Eva Braunwarth, Raffaele Brustia, Daniele Sommacale, Giorgia A Rodda, Hicham Kobeiter, Rafael Duran, Alban Denys, Nicolas Demartines, Emmanuel Melloul

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引用次数: 0

Abstract

Background: An international registry on liver venous deprivation (LVD, simultaneous portal and hepatic vein embolization) was created in 2020. This study assessed the outcomes after LVD in patients included in the registry.

Methods: Eight international centers participated. Future liver remnant (FLR) and standardized FLR ratios were defined as FLR/total functional liver volume and FLR/total estimated liver volume.

Results: 216 patients were included (80 women, median age 63). Main surgical indication was colorectal metastases (n=124). Median and standardized FLR ratios before LVD were 33% (IQR27-47) and 32% (IQR24-39). In one patient, right hepatic vein embolization failed. Complications after LVD occurred in 14 patients (6.5%). After LVD, median and standardized FLR ratios significantly increased to 46% (IQR38-60, p<0.001) and 44% (IQR35-51, p<0.001), corresponding to a median kinetic growth rate of 3.4%/week (IQR1.5-6.0). Hepatectomy was performed in 160 patients (72 extended hepatectomies), while 56 dropped out (4% insufficient hypertrophy, 13% tumor progression). Seventy-seven patients had postoperative complications (48%; 5 postoperative liver failures, 3%). Median Comprehensive Complication Index was 20.9 (IQR0-30.8).

Conclusion: Preliminary data of this international registry showed that LVD had a high technical success rate with few post-procedural complications and significant kinetic growth. Major hepatectomy after LVD appeared to be safe.

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来自国际肝静脉剥夺登记（EuroLVD）的第一批结果。

背景：国际肝静脉剥夺（LVD，同时门静脉和肝静脉栓塞）注册于2020年创建。本研究评估了纳入登记的患者LVD后的结果。方法：8个国际中心参与。未来肝残量（FLR）和标准化肝残量比定义为FLR/总功能肝体积和FLR/总估计肝体积。结果：共纳入216例患者（女性80例，中位年龄63岁）。主要手术指征为结直肠转移（n=124）。LVD前的中位FLR和标准化FLR分别为33% （IQR27-47）和32% （IQR24-39）。1例患者肝右静脉栓塞失败。LVD后并发症14例（6.5%）。LVD后，中位FLR和标准化FLR显著增加至46% （IQR38-60, p）。结论：该国际注册的初步数据显示，LVD技术成功率高，术后并发症少，动态生长显著。LVD后的主要肝切除术似乎是安全的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Hpb GASTROENTEROLOGY & HEPATOLOGY-SURGERY

CiteScore

5.60

自引率

3.40%

发文量

244

审稿时长

57 days

期刊介绍： HPB is an international forum for clinical, scientific and educational communication. Twelve issues a year bring the reader leading articles, expert reviews, original articles, images, editorials, and reader correspondence encompassing all aspects of benign and malignant hepatobiliary disease and its management. HPB features relevant aspects of clinical and translational research and practice. Specific areas of interest include HPB diseases encountered globally by clinical practitioners in this specialist field of gastrointestinal surgery. The journal addresses the challenges faced in the management of cancer involving the liver, biliary system and pancreas. While surgical oncology represents a large part of HPB practice, submission of manuscripts relating to liver and pancreas transplantation, the treatment of benign conditions such as acute and chronic pancreatitis, and those relating to hepatobiliary infection and inflammation are also welcomed. There will be a focus on developing a multidisciplinary approach to diagnosis and treatment with endoscopic and laparoscopic approaches, radiological interventions and surgical techniques being strongly represented. HPB welcomes submission of manuscripts in all these areas and in scientific focused research that has clear clinical relevance to HPB surgical practice. HPB aims to help its readers - surgeons, physicians, radiologists and basic scientists - to develop their knowledge and practice. HPB will be of interest to specialists involved in the management of hepatobiliary and pancreatic disease however will also inform those working in related fields. Abstracted and Indexed in: MEDLINE® EMBASE PubMed Science Citation Index Expanded Academic Search (EBSCO) HPB is owned by the International Hepato-Pancreato-Biliary Association (IHPBA) and is also the official Journal of the American Hepato-Pancreato-Biliary Association (AHPBA), the Asian-Pacific Hepato Pancreatic Biliary Association (A-PHPBA) and the European-African Hepato-Pancreatic Biliary Association (E-AHPBA).