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首页> 外文期刊>Surgical Endoscopy >Preoperative biliary drainage of the hepatic lobe to be resected does not affect liver hypertrophy after percutaneous transhepatic portal vein embolization
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Preoperative biliary drainage of the hepatic lobe to be resected does not affect liver hypertrophy after percutaneous transhepatic portal vein embolization

机译：待切除的肝叶的术前胆道引流不会影响经皮胸腔静脉栓塞后的肝肥大

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Background In patients with malignant perihilar biliary strictures, preoperative biliary drainage (PBD) of the hepatic lobe to be resected may decrease the liver volume of the future liver remnant (FLR) after percutaneous transhepatic portal vein embolization (PVE). However, evidence of its application is insufficient. This study aimed to clarify the effects of PBD on liver hypertrophy after PVE. Methods Between January 2008 and December 2017, 169 patients with malignant perihilar biliary strictures underwent major hepatectomy or palliative surgery at our hospital. Of these, 76 patients who underwent PVE were categorized into two groups: group A (n = 29) who received unilateral PBD of the FLR and group B (n = 47) who received bilateral PBD, including that of the hepatic lobe to be resected. FLR ratios after PVE and liver hypertrophy ratios were retrospectively compared in both groups. Results Group B exhibited significantly severe biliary stenosis (p = 0.0038) and high serum bilirubin before biliary drainage (p = 0.0037). After PVE, the total liver volumes were 1287 +/- 260 ml and 1340 +/- 257 ml (p = 0.39), respectively. FLR volumes were 555 +/- 135 and 577 +/- 113 ml (p = 0.45), respectively. FLR ratios were 43.4 +/- 8.2% and 43.4 +/- 6.4%, respectively (p = 0.98). Liver hypertrophy ratios were 124.2 +/- 17.7% and 129.2 +/- 20.9%, respectively (p = 0.28). In addition, an examination which excluded patients with Bismuth type I obtained similar result. Conclusions PBD of the hepatic lobe to be resected did not decrease the FLR ratios and hypertrophy ratios. Thus, in patients with poor biliary drainage, additional PBD of the target lobe is acceptable.
机译：背景技术在患有恶性无血管胆道的患者中，待切除的肝叶的术前胆道引流（PBD）可能会在经皮转发门静脉栓塞（PVE）后未来肝脏残留（FLR）的肝脏体积降低。但是，其申请证据不足。本研究旨在阐明PBD对PVE后肝肥大的影响。方法2008年1月至2017年12月，169例恶性无恶性胆道患者在我们医院接受过主要肝切除术或姑息性手术。其中76名接受PVE的患者分为两组：A组（n = 29），接受了接受双侧PBD的单方面PBD（N = 47），包括肝叶的肝叶片。在两个组中回顾性和肝脏肥大比率后的FLR比率。结果B组在胆道引流前展示了较严重的胆道狭窄（P = 0.0038）和高血清胆红素（P = 0.0037）。 PVE后，总肝体积分别为1287 +/- 260ml，分别为1340 +/- 257ml（p = 0.39）。 FLR体积分别为555 +/- 135和577 +/- 113ml（p = 0.45）。 FLR比例分别为43.4 +/- 8.2％和43.4 +/- 6.4％（P = 0.98）。肝肥大比例分别为124.2 +/- 17.7％和129.2 +/- 20.9％（p = 0.28）。此外，我获得了类似结果的铋型患者的检查。结论待切除肝叶的PBD未降低FLR比和肥大比率。因此，在胆道引流差的患者中，靶叶的额外PBD是可接受的。

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