Liver Vein Deprivation versus Portal Vein Embolization: Retrospective Review of Safety and Effectiveness.

Abstract

Purpose: To compare the safety and effectiveness of liver vein deprivation (LVD) and portal vein embolization (PVE) in patients scheduled to undergo liver resection.

Materials and methods: This retrospective cohort study included 59 patients who underwent either PVE (n = 28) or LVD (n = 31) in preparation for liver resection. The primary outcome was percent change in future liver remnant volume (FLRV). The secondary endpoints were degree of hypertrophy (DH) and kinetic growth rate (KGR).

Results: Low baseline FLRV and time interval in days between the procedure and follow-up imaging (Ti) positively impacted the primary and secondary endpoints in both groups. Percent change in FLRV was higher in the LVD group (52.8% ± 5.3) than in the PVE group (22.3% ± 3.0, P < .001). DH was also higher in the LVD group (15.4% ± 1.7) than in the PVE group (6.4% ± 0.9, P < .001). KGR did not differ significantly between groups (LVD, 0.54%/d ± 0.06; PVE, 0.35%/d ± 0.1; P = .239). When patients with a baseline standardized FLRV of >35% were excluded from the analysis, the LVD group demonstrated higher values than the PVE group in KGR (0.57%/d ± 0.06 vs 0.29%/d ± 0.05, P < .001), percent change in FLRV (64.2% ± 6.0 vs 25.9% ± 4.3, P < .001), and DH (15.4% ± 1.4 vs 6.6% ± 1.0, P < .001). No adverse events were noted in either group.

Conclusions: LVD appears to be safe and may be superior to PVE in inducing hypertrophy of future liver remnant in patients scheduled to undergo surgical resection.