Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Hepatol. Oct 8, 2016; 8(28): 1200-1204
Published online Oct 8, 2016. doi: 10.4254/wjh.v8.i28.1200
Impaired liver function attenuates liver regeneration and hypertrophy after portal vein embolization
Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto
Yumiko Kageyama, Takashi Kokudo, Katsumi Amikura, Yoshihiro Miyazaki, Amane Takahashi, Hirohiko Sakamoto, Division of Gastroenterological Surgery, Saitama Cancer Center, Kita-adachi gun, Saitama Prefecture 362-0806, Japan
Author contributions: Kageyama Y designed and performed the research and wrote the paper; Kokudo T contributed to the analysis and supervised the report; Amikura K designed the research and supervised the report; Miyazaki Y, Takahashi A and Sakamoto H supervised the report.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of the Saitama Cancer Center.
Informed consent statement: Patients were not required to give informed consent because the analysis used anonymous clinical data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: We have no financial relationships to disclose.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Takashi Kokudo, MD, Division of Gastroenterological Surgery, Saitama Cancer Center, 780 Komuro, Ina, Kita-adachi gun, Saitama Prefecture 362-0806, Japan. kokudo-tky@umin.ac.jp
Telephone: +81-48-7221111 Fax: +81-48-7221129
Received: May 15, 2016
Peer-review started: May 17, 2016
First decision: June 14, 2016
Revised: June 26, 2016
Accepted: August 15, 2016
Article in press: August 16, 2016
Published online: October 8, 2016
Processing time: 137 Days and 3.2 Hours
Abstract
AIM

To clarify the clinical factors associated with liver regeneration after major hepatectomy and the hypertrophic rate after portal vein embolization (PVE).

METHODS

A total of 63 patients who underwent major hepatectomy and 13 patients who underwent PVE in a tertiary care hospital between January 2012 and August 2015 were included in the analysis. We calculated the remnant liver volume following hepatectomy using contrast-enhanced computed tomography (CT) performed before and approximately 3-6 mo after hepatectomy. Furthermore, we calculated the liver volume using CT performed 2-4 wk after PVE. Preoperative patient characteristics and laboratory data were analyzed to identify factors affecting postoperative liver regeneration or hypertrophy rate following PVE.

RESULTS

The remnant liver volume/total liver volume ratio negatively correlated with the liver regeneration rate after hepatectomy (ρ = -0.850, P < 0.001). The regeneration rate was significantly lower in patients with an indocyanine green retention rate at 15 min (ICG-R15) of ≥ 20% in the right hepatectomy group but not in the left hepatectomy group. The hypertrophic rate after PVE positively correlated with the regeneration rate after hepatectomy (ρ = 0.648, P = 0.017). In addition, the hypertrophic rate after PVE was significantly lower in patients with an ICG-R15 ≥ 20% and a serum total bilirubin ≥ 1.5 mg/dL.

CONCLUSION

The regeneration rate after major hepatectomy correlated with hypertrophic rate after PVE. Both of them were attenuated in the presence of impaired liver function.

Keywords: Regeneration after hepatectomy; Major hepatectomy; Portal vein embolization; Clinical factors; Hypertrophy

Core tip: Little is known about the clinical factors associated with liver regeneration after major hepatectomy. In the present study, the liver regeneration rate after major hepatectomy correlated with the remnant liver volume and hypertrophic rate after portal vein embolization. The regeneration rate after major hepatectomy and hypertrophic rate after portal vein embolization were attenuated in the presence of impaired liver function.