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01.09.2009 | Ausgabe 9/2009

World Journal of Surgery 9/2009

Increase in the Serum Bile Acid Level Predicts the Effective Hypertrophy of the Nonembolized Hepatic Lobe After Right Portal Vein Embolization

Zeitschrift:
World Journal of Surgery > Ausgabe 9/2009
Autoren:
Hiromitsu Hayashi, Toru Beppu, Hiroki Sugita, Kei Horino, Hiroyuki Komori, Toshiro Masuda, Hirohisa Okabe, Hiroshi Takamori, Hideo Baba

Abstract

Background

The purpose of the present study was to investigate the clinical association between serum bile acid level changes and liver hypertrophy in portal vein embolization (PVE).

Methods

In 31 patients, the serum total bile acid level was prospectively measured before and 1, 3, 5, 7, and 14 days after right PVE. Computed tomographic volumetry was performed before and 25.0 ± 3.6 days after PVE.

Results

Portal vein embolization induced the liver hypertrophy with a median increase in the left lobe volume (ILV) of 165 cm3 and a median percentage ILV (%ILV) of 29%. Compared with the pretreatment level, the serum bile acid levels significantly increased on day 3 and day 14 after PVE (p = 0.017 and p = 0.003, respectively). In patients with greater hypertrophy after PVE (ILV > 165 cm3 and %ILV > 30%), the increases in the bile acid level on day 3 were larger than that in those with lesser hypertrophy (p = 0.008 and p = 0.002, respectively). The increase on day 3 positively correlated with the ILV and %ILV (p = 0.003 and p = 0.004, respectively). The serum bile acid levels on day 3, 5, and 7 after PVE increased in patients with %ILV > 30% but not in those with %ILV ≤ 30%.

Conclusions

Portal vein embolization increases the serum bile acid level in patients with effective liver hypertrophy in the nonembolized lobe. The increase on day 3 is a useful predictor of effective hypertrophy of the nonembolized lobe. Thus, bile acid signaling may be important for liver regeneration post-PVE.

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