Published online Oct 8, 2016. doi: 10.4254/wjh.v8.i28.1200
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
To clarify the clinical factors associated with liver regeneration after major hepatectomy and the hypertrophic rate after portal vein embolization (PVE).
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.
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.
The regeneration rate after major hepatectomy correlated with hypertrophic rate after PVE. Both of them were attenuated in the presence of impaired liver function.
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.