Intrahepathic portal revascularization following right portal vein ligation
A case report
Keywords:
PORTAL VEIN LIGATION, TWO-STAGE HEPATECTOMY, NEOPLASM METASTASIS, LIVER NEOPLASMS, COLORECTAL NEOPLASMS
Abstract
Left or right portal vein ligation to prevent post-operative liver failure in the case of extreme hepatectomy constitutes a procedure with a good prognosis, as it causes contralateral liver hypertrophy.
However, its revascularization has been proved by intrahepatic porto-portal anastomoses, which could result in a reduction of the expected or required hypertrophy.
The study aims to record a clinical case of intrahepatic revascularization of the portal vein, an unwanted event of the two-stage hepatectomy to treat bilobar hepatic metastasis of colorectal origin, and describe alternatives to avoid or treat such revascularization.
References
(1) Isfordink CJ, Samim M, Braat MNGJA, Almalki AM, Hagendoorn J, Borel Rinkes IHM, et al. Portal vein ligation versus portal vein embolization for induction of hypertrophy of the future liver remnant: a systematic review and meta-analysis. Surg Oncol 2017; 26(3):257-67.
(2) Zeile M, Bakal A, Volkmer JE, Stavrou GA, Dautel P, Hoeltje J, et al. Identification of cofactors influencing hypertrophy of the future liver remnant after portal vein embolization-the effect of collaterals on embolized liver volume. Brit J Radiol 2016; 89(1068): 1-7.
(3) van Lienden KP, Hoekstra LT, Bennink RJ, van Gulik TM. Intrahepatic left to right portoportal venous collateral vascular formation in patients undergoing right portal vein ligation. Cardiovasc Intervent Radiol 2013; 36(6):1572-9.
(4) Broering DC, Hillert C, Krupski G, Fischer L, Mueller L, Achilles EG, et al. Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant. J Gastrointest Surg 2002; 6(6):905-13.
(5) Biggemann L, Uhlig J, Streit U, Sack H, Guo XC, Jung C, et al. Future liver remnant growth after various portal vein embolization regimens: a quantitative comparison. Minim Invasive Ther Allied Technol 2020; 29(2):98-106.
(6) Denys AL, Abehsera M, Sauvanet A, Sibert A, Belghiti J, Menu Y. Failure of right portal vein ligation to induce left lobe hypertrophy due to intrahepatic portoportal collaterals: successful treatment with portal vein embolization. AJR Am J Roentgenol 1999; 173:633-5.
(7) Russolillo N, Langella S, Perotti S, Balbo Mussetto A, Lo Tesoriere R, Cirillo S, et al. Alcohol injection into the portal vein prior to ligation increases liver regeneration rate. HPB(Oxford) 2018; 20(8):739-44.
(8) Schadde E, Guiu B, Deal R, Kalil J, Arslan B, Tasse J, et al. Simultaneous hepatic and portal vein ligation induces rapid liver hypertrophy: a study in pigs. Surgery 2019; 165(3):525-33.
(2) Zeile M, Bakal A, Volkmer JE, Stavrou GA, Dautel P, Hoeltje J, et al. Identification of cofactors influencing hypertrophy of the future liver remnant after portal vein embolization-the effect of collaterals on embolized liver volume. Brit J Radiol 2016; 89(1068): 1-7.
(3) van Lienden KP, Hoekstra LT, Bennink RJ, van Gulik TM. Intrahepatic left to right portoportal venous collateral vascular formation in patients undergoing right portal vein ligation. Cardiovasc Intervent Radiol 2013; 36(6):1572-9.
(4) Broering DC, Hillert C, Krupski G, Fischer L, Mueller L, Achilles EG, et al. Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant. J Gastrointest Surg 2002; 6(6):905-13.
(5) Biggemann L, Uhlig J, Streit U, Sack H, Guo XC, Jung C, et al. Future liver remnant growth after various portal vein embolization regimens: a quantitative comparison. Minim Invasive Ther Allied Technol 2020; 29(2):98-106.
(6) Denys AL, Abehsera M, Sauvanet A, Sibert A, Belghiti J, Menu Y. Failure of right portal vein ligation to induce left lobe hypertrophy due to intrahepatic portoportal collaterals: successful treatment with portal vein embolization. AJR Am J Roentgenol 1999; 173:633-5.
(7) Russolillo N, Langella S, Perotti S, Balbo Mussetto A, Lo Tesoriere R, Cirillo S, et al. Alcohol injection into the portal vein prior to ligation increases liver regeneration rate. HPB(Oxford) 2018; 20(8):739-44.
(8) Schadde E, Guiu B, Deal R, Kalil J, Arslan B, Tasse J, et al. Simultaneous hepatic and portal vein ligation induces rapid liver hypertrophy: a study in pigs. Surgery 2019; 165(3):525-33.
Published
2020-12-01
How to Cite
1.
González MC, Vanerio P, Pereyra J, Pérez M del C, Andreoli G, Valiñas R. Intrahepathic portal revascularization following right portal vein ligation. Rev. Méd. Urug. [Internet]. 2020Dec.1 [cited 2024Nov.24];36(4):455-8. Available from: https://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/653
Section
Clinical Cases
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