Article (Scientific journals)
Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.
Heil, J.; Korenblik, R.; Heid, F. et al.
2021In British Journal of Surgery
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Keywords :
transplantation; liver; surgery; cancer; metastasis; resection; foie; metastase; chirurgie; hépatectomie
Abstract :
[en] BACKGROUND: The extent of liver resection for tumours is limited by the expected functional reserve of the future liver remnant (FRL), so hypertrophy may be induced by portal vein embolization (PVE), taking 6 weeks or longer for growth. This study assessed the hypothesis that simultaneous embolization of portal and hepatic veins (PVE/HVE) accelerates hypertrophy and improves resectability. METHODS: All centres of the international DRAGON trials study collaborative were asked to provide data on patients who had PVE/HVE or PVE on 2016-2019 (more than 5 PVE/HVE procedures was a requirement). Liver volumetry was performed using OsiriX MD software. Multivariable analysis was performed for the endpoints of resectability rate, FLR hypertrophy and major complications using receiver operating characteristic (ROC) statistics, regression, and Kaplan-Meier analysis. RESULTS: In total, 39 patients had undergone PVE/HVE and 160 had PVE alone. The PVE/HVE group had better hypertrophy than the PVE group (59 versus 48 per cent respectively; P = 0.020) and resectability (90 versus 68 per cent; P = 0.007). Major complications (26 versus 34 per cent; P = 0.550) and 90-day mortality (3 versus 16 per cent respectively, P = 0.065) were comparable. Multivariable analysis confirmed that these effects were independent of confounders. CONCLUSION: PVE/HVE achieved better FLR hypertrophy and resectability than PVE in this collaborative experience.
Disciplines :
Radiology, nuclear medicine & imaging
Gastroenterology & hepatology
Author, co-author :
Heil, J.
Korenblik, R.
Heid, F.
Bechstein, W. O.
Bemelmans, M.
Binkert, C.
Björnsson, B.
Breitenstein, S.
Detry, Olivier  ;  Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne
Dili, A.
Dondelinger, Robert ;  Université de Liège - ULiège > Département des sciences cliniques > Département des sciences cliniques
GERARD, Laurent ;  Centre Hospitalier Universitaire de Liège - CHU > Département de Physique Médicale > Service médical de radiodiagnostic
Giménez-Maurel, T.
Guiu, B.
Heise, D.
Hertl, M.
Kalil, J. A.
Klein, J. J.
Lakoma, A.
Neumann, U. P.
Olij, B.
Pappas, S. G.
Sandström, P.
Schnitzbauer, A.
Serrablo, A.
Tasse, J.
Van der Leij, C.
Metrakos, P.
Van Dam, R.
Schadde, E.
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Language :
Title :
Preoperative portal vein or portal and hepatic vein embolization: DRAGON collaborative group analysis.
Publication date :
Journal title :
British Journal of Surgery
Publisher :
John Wiley & Sons, Hoboken, United States - New Jersey
Peer reviewed :
Peer Reviewed verified by ORBi
Commentary :
© The Author(s) 2021. Published by Oxford University Press on behalf of BJS Society Ltd. All rights reserved. For permissions, please email:
Available on ORBi :
since 06 March 2021


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