Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma

[en] Background: Major hepatectomy in perihilar cholangiocarcinoma (pCCA) patients with a small future liver remnant (FLR) risks posthepatectomy liver failure (PHLF). This study examines combined portal and hepatic vein embolisation (PVE/HVE) to increase preoperative FLR volume and potentially decrease PHLF rates. Methods: In this retrospective, multicentre, observational study, data was collected from centres affiliated with the DRAGON Trials Collaborative and the EuroLVD registry. The study included pCCA patients who underwent PVE/HVE between July 2016 and January 2023. Results: Following PVE/HVE, 28% of patients (9/32) experienced complications, with 22% (7/32) necessitating biliary interventions for cholangitis. The median degree of hypertrophy after a median of 16 days was 16% with a kinetic growth rate of 6.8% per week. 69% of patients (22/32) ultimately underwent surgical resection. Cholangitis after PVE/HVE was associated with unresectability. After resection, 55% of patients (12/22) experienced complications, of which 23% (5/22) were Clavien-Dindo grade III or higher. The 90-day mortality after resection was 0%. Conclusion: PVE/HVE quickly enhances the kinetic growth rate in pCCA patients. Cholangitis impairs chances on resection significantly. Resection after PVE/HVE is associated with low levels of 90-day mortality. The study highlights the potential of PVE/HVE in improving safety and outcomes in pCCA undergoing resection.

Disciplines :

Surgery
Gastroenterology & hepatology

Author, co-author :

Smits, Jens

Chau, Steven

James, Sinead

Korenblik, Remon

Tschögl, Madita

Arntz, Pieter

Bednarsch, Jan

Abreu de Carvalho, Luis

Detry, Olivier ; Université de Liège - ULiège > Département des sciences cliniques > Pathologie chirurgicale abdominale et endocrinienne

Erdmann, Joris

More authors (10 more)

Language :

English

Title :

Combined portal and hepatic vein embolisation in perihilar cholangiocarcinoma

Publication date :

December 2024

Journal title :

HPB

ISSN :

1365-182X

eISSN :

1477-2574

Publisher :

Elsevier BV

Volume :

Issue :

Pages :

1458-1466

Peer reviewed :

Peer Reviewed verified by ORBi

Additional URL :

https://api.elsevier.com/content/article/PII:S1365182X24022196?httpAccept=text/xml

Available on ORBi :

since 14 September 2024

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