Erschienen in:
28.02.2020 | Hepatobiliary Tumors
Portal Vein Embolization for Perihilar Cholangiocarcinoma: A Story Worth Repeating
verfasst von:
Hop S. Tran Cao, MD, FACS, Jean-Nicolas Vauthey, MD, FACS
Erschienen in:
Annals of Surgical Oncology
|
Ausgabe 7/2020
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Excerpt
Three decades ago, Makuuchi and colleagues shared with the world their preliminary experience with preoperative portal vein embolization (PVE).
1 The 14 patients discussed in their report all had perihilar carcinoma (PHC) and would require extended hepatectomy. Although two patients died within 3 months of surgery, the early results were encouraging, demonstrating low rates of postoperative liver failure and bile leak. Olthof et al.
2 have now retold this compelling story through a retrospective multi-institutional, multinational cohort study in which 1667 patients with PHC treated at 20 centers were evaluated. Through propensity score matching, the benefits of PVE are clearly demonstrated, with a significant reduction in the rates of postoperative liver failure (8% vs. 36%), biliary leakage (10% vs. 35%), intra-abdominal abscess (19% vs. 34%), and 90-day mortality (7% vs. 18%). Their rightful conclusion echoed what should by now be a familiar refrain to hepatobiliary surgeons: PVE is an integral component of liver surgery, especially as it pertains to the treatment of PHC. Importantly, the current version of the story also raises some important issues worth addressing. …
