PORTAL VEIN EMBOLIZATION AS PREOPERATIVE MODALITY FOR PATIENTS WITH INTRAHEPATIC CHOLANGIOCARCINOMA

Authors

  • O. YU. USENKO State institute “Shalimov’s National Scientific Center of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0003-4957-4104
  • A. I. ZHYLENKO State institute “Shalimov’s National Scientific Center of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine, Kyiv, Ukraine https://orcid.org/0000-0002-7117-5401

DOI:

https://doi.org/10.11603/2414-4533.2024.1.14647

Keywords:

intrahepatic cholangiocarcinoma, liver resection, portal vein embolization

Abstract

The aim of the work: to evaluate the short-term outcomes of surgical treatment of patients with ICC after performing PVE at the preope­rative stage.

Materials and methods. 84 patients with ICC underwent radical surgery from 2004 to 2018, in the Department of Liver transplantation and surgery of the State University “National Scientific Center of Surgery and Transplantology named after O.O. Shalimov” of the State institute “Shalimov’s National Scientific Center of Surgery and Transplantation” of the National Academy of Medical Sciences of Ukraine. The main group consisted of 21 (25 %) patients who underwent PVE as a preoperative preparation, and the control group – 63 (75 %) patients whom PVE was not performed.

Results and Discussion. During the 90-day period, clinically significant postoperative complications (grade IIIa–IV according to the Clavien–Dindo classification) were observed in 6 (28.5 %) cases among patients of the main group and 13 (20.6 %) cases among patients of the control group (р= 0.002). Clinically significant postoperative liver failure according to ISGLS criteria occurred in 5 (23.8 %) patients of the main group and 12 (19 %) patients of the control group (p=0.305). Reoperation was performed in 1 (4.7 %) case in the main group and in 7 (11.1 %) cases in the control group. Postoperative mortality was 3.1 % – 2 patients of the control group, while among the patients of the main group, postoperative mortality was not noted.

PVE as a method of preoperative preparation is able to provide satisfactory indicators of postoperative complications against the background of extensive liver resections both in isolation and simultaneously with vasculobiliary interventions.

References

Bridgewater J, Galle PR, Khan SA, Llovet JM, Park JW, Patel T, Gores GJ Guidelines for the diagnosis and management of intrahepatic cholangiocarcinoma. Journal of Hepatology. 2014;60(6): 1268-89.

Esnaola NF, Meyer JE, Karachristos A, Maranki JL, Camp ER, Denlinger CS Evaluation and management of intrahepatic and extrahepatic cholangiocarcinoma. Cancer. 2016;122(9): 1349-69.

Nagino M, Kamiya J, Nishio H, Ebata T, Arai T, Nimura Y Two hundred forty consecutive portal vein embolizations before extended hepatectomy for biliary cancer: surgical outcome and long-term follow-up. Annals of Surgery. 2006;243(3): 364-72.

Guglielmi A et al. How much remnant is enough in liver resection? Digestive surgery. 2012; 29 (1): 6-17. URL: https://doi.org/10.1159/000335713(date of access: 03.03.2024).

Lang H, Baumgart J, Heinrich S, Huber T, Heuft LK, Margies R, Bartsch F. Liver resection for intrahepatic cholangiocarcinoma – single-center experience with 286 patients undergoing surgical exploration over a thirteen year period. Journal of Clinical Medicine. 2021;10(16); 3559.

Radtke A, Königsrainer A. Surgical therapy of cholangiocarcinoma. Visceral Medicine. 2016;32(6); 422-6. URL: https://doi.org/10.1159/000452921

Wang K, Zhang H, Xia Y, Liu J, Shen F. Surgical options for intrahepatic cholangiocarcinoma. Hepatobiliary Surgery and Nutrition. 2017;6(2): 79. URL: https://doi.org/10.21037/hbsn.2017.01.06(date of access: 03.03.2024)..

Spolverato G, Kim Y, Alexandrescu S, Popescu I, Marques HP, Aldrighetti L, Pawlik TM Is hepatic resection for large or multifocal intrahepatic cholangiocarcinoma justified? Results from a multi-institutional collaboration. Annals of Surgical Oncology. 2015;22: 2218-25.

Spolverato G, Kim Y, Ejaz A, Alexandrescu S, Marques H, Aldrighetti L Pawlik TM Conditional probability of long-term survival after liver resection for intrahepatic cholangiocarcinoma: a multi-institutional analysis of 535 patients. JAMA Surgery. 2015;150(6): 538-45.

Kishi Y, Vauthey J-N Issues to be considered to address the future liver remnant prior to major hepatectomy. Surgery today. 2020. URL: https://doi.org/10.1007/s00595-020-02088-2.

Khan AS, Garcia-Aroz S, Ansari MA, Atiq SM, Senter-Zapata M, Fowler K, Chapman WC Assessment and optimization of liver volume before major hepatic resection: Current guidelines and a narrative review // International journal of surgery. 2018;52: 74-81.URL: https://doi.org/10.1016/j.ijsu.2018.01.042.

Madoff DC, Odisio BC, Schadde E, Gaba RC, Bennink R J, van Gulik TM, Guiu B Improving the safety of major resection for hepatobiliary malignancy: portal vein embolization and recent innovations in liver regeneration strategies. Current oncology reports. 2020;22: 1-20.

Yeom Y K, Shin JH Complications of portal vein embolization: evaluation on cross-sectional imaging. Korean Journal of Radiology. 2015;16(5): 1079. URL: https://doi.org/10.3348/kjr.2015.16.5.1079.

Orcutt ST, Kobayashi K, Sultenfuss M, Hailey BS, Sparks A, Satpathy B, Anaya DA Portal vein embolization as an oncosurgical strategy prior to major hepatic resection: anatomic, surgical, and technical considerations. Frontiers in Surgery. 2016;3: 14.

Zhang X F, Bagante F, Chakedis J, Moris D, Beal EW, Weiss M, Pawlik TM Perioperative and long-term outcome for intrahepatic cholangiocarcinoma: impact of major versus minor hepatectomy. Journal of Gastrointestinal Surgery. 2017;21(11): 1841-50.

Ma KW, Cheung TT, She WH, Chok KSH, Chan ACY, Dai WC, Lo CM Major postoperative complications compromise oncological outcomes of patients with intrahepatic cholangiocarcinoma after curative resection–A 13-year cohort in a tertiary center. Asian journal of surgery. 2019;42(1): 164-71.

Downloads

Published

2023-03-04

How to Cite

USENKO, O. Y., & ZHYLENKO, A. I. (2023). PORTAL VEIN EMBOLIZATION AS PREOPERATIVE MODALITY FOR PATIENTS WITH INTRAHEPATIC CHOLANGIOCARCINOMA . Hospital Surgery. Journal Named by L.Ya. Kovalchuk, (1), 68–75. https://doi.org/10.11603/2414-4533.2024.1.14647

Issue

No. 1 (2024)

Section

EXPERIENCE OF WORK

License

Copyright (c) 2024 О. Ю. УСЕНКО, А. І. ЖИЛЕНКО

Creative Commons License

This work is licensed under a Creative Commons Attribution 4.0 International License.

Authors who publish their work in Hospital Surgery. Journal by L. Ya. Kovalchuk agree to the following terms:

  1. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.  
  2. Лицензия Creative Commons
  3. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
  4. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access)