Laparoscopic hepatic vein deprivation_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

LIAO Yubo ^1,2 , YUAN Chengxiang ^1,2 , ZHANG Na ³ , WU Gang ² , CHENG Donghui ² , YANG Chong ⁴ , JIANG Jipeng ² , LIAO Dongxu ² ,  ZHANG Yu ^1,2

1. School of Medicine, Chengdu Medical College, Chengdu 610500, P. R. China;
2. Department of Hepatobiliary and Pancreatic Surgery, SichuanProvincial People’s Hospital, University of Electronic Science and technology, Chengdu 610072, P. R. China;
3. The 5th Assignment Outpatient Department, Western Theater General Hospital, Chengdu 610083, P. R. China;
4. Organ Transplantation Center, Sichuan Provincial People’s Hospital, University of Electronic Science and Technology of China, Chengdu 610072, P. R. China;

Corresponding author：

ZHANG Yu, Email: 68532815@qq.com

Keywords：

laparoscope; liver venous deprivation; two-step hepatectomy; pancreatic neuroendocrine tumor

DOI：

10.7507/1007-9424.202206019

Video：

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Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the value of laparoscopic liver venous deprivation (LLVD) in promoting the growth of contralateral future liver remnant (FLR) during two-step hepatectomy. Method The clinicopathologic data of a 45-year-old female patient with pancreatic neuroendocrine tumor with multiple liver metastases (grade G2) treated by two-step hepatectomy based on LLVD in January 2022 in the Sichuan Provincial People’s Hospital were analyzed retrospectively. Results The liver function returned to normal within 10 d after LLVD, and the relative increase ratio of FLR reached to 98.35% on postoperative day 10. The laparoscopic right hemi-hepatectomy and distal pancreatectomy plus splenectomy was performed without any postoperative complications, and the patient was discharged from hospital on postoperative day 8. No tumor recurrence or metastasis occurred during the follow-up period. Conclusions From the analysis results of this case, the LLVD could promote the growth of FLR safely and effectively. LLVD provides an alternative surgical method of two-step hepatectomy for treatment of benign and malignant liver tumors.

Citation： LIAO Yubo, YUAN Chengxiang, ZHANG Na, WU Gang, CHENG Donghui, YANG Chong, JIANG Jipeng, LIAO Dongxu, ZHANG Yu. Laparoscopic hepatic vein deprivation. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2022, 29(12): 1568-1572. doi: 10.7507/1007-9424.202206019 Copy

1.	Søreide JA, Deshpande R. Post hepatectomy liver failure (PHLF)—Recent advances in prevention and clinical management. Eur J Surg Oncol, 2021, 47(2): 216-224.
2.	Beppu T, Yamamura K, Okabe H, et al. Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma. Ann Gastroenterol Surg, 2020, 5(3): 287-295.
3.	Lang H, Baumgart J, Mittler J. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) registry: what have we learned? Gut Liver, 2020, 14(6): 699-706.
4.	杨冲, 杨洪吉, 邓绍平, 等. 剩余肝体积不足的晚期肝泡型包虫外科治疗进展. 中国普通外科杂志, 2021, 30(1): 98-104.
5.	张宇. ALPPS的衍生术式与评价. 中国普外基础与临床杂志, 2016, 23(1): 9-13.
6.	Kim D, Cornman-Homonoff J, Madoff DC. Preparing for liver surgery with “Alphabet Soup”: PVE, ALPPS, TAE-PVE, LVD and RL. Hepatobiliary Surg Nutr, 2020, 9(2): 136-151.
7.	李富贵, 严律南, 李波, 等. 中国成人标准肝体积评估公式的临床研究. 四川大学学报(医学版), 2009, 40(2): 302-306.
8.	Ito T, Igarashi H, Jensen RT. Therapy of metastatic pancreatic neuroendocrine tumors (pNETs): recent insights and advances. J Gastroenterol, 2012, 47(9): 941-960.
9.	Andreasi V, Muffatti F, Guarneri G, et al. Surgical principles in the management of pancreatic neuroendocrine neoplasms. Curr Treat Options Oncol, 2020, 21(6): 48. doi: 10.1007/s11864-020-00736-w.
10.	吴文铭, 陈洁, 白春梅, 等. 中国胰腺神经内分泌肿瘤诊疗指南(2020). 协和医学杂志, 2021, 12(4): 460-480.
11.	Yamao T, Tamura Y, Hayashi H, et al. Novel approach via the round ligament in portal vein embolization. World J Surg, 2021, 45(9): 2878-2885.
12.	Chebaro A, Buc E, Durin T, et al. Liver venous deprivation or associating liver partition and portal vein ligation for staged hepatectomy?: a retrospective multicentric study. Ann Surg, 2021, 274(5): 874-880.
13.	Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg, 2012, 255(3): 405-414.
14.	Hwang S, Lee SG, Ko GY, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann Surg, 2009, 249(4): 608-616.
15.	Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surg Nutr, 2020, 9(5): 564-576.
16.	Guiu B, Quenet F, Escal L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function. Eur Radiol, 2017, 27(8): 3343-3352.
17.	Deshayes E, Schadde E, Piron L, et al. Extended liver venous deprivation leads to a higher increase in liver function that ALPPS in early assessment: a comment to “Sparrelid, E. et al. dynamic evaluation of liver volume and function in associating liver partition and portal vein ligation for staged hepatectomy. Journal of Gastrointestinal Surgery (2017)”. J Gastrointest Surg, 2017, 21(10): 1754-1755.

1. Søreide JA, Deshpande R. Post hepatectomy liver failure (PHLF)—Recent advances in prevention and clinical management. Eur J Surg Oncol, 2021, 47(2): 216-224.
2. Beppu T, Yamamura K, Okabe H, et al. Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma. Ann Gastroenterol Surg, 2020, 5(3): 287-295.
3. Lang H, Baumgart J, Mittler J. Associated liver partition and portal vein ligation for staged hepatectomy (ALPPS) registry: what have we learned? Gut Liver, 2020, 14(6): 699-706.
4. 杨冲, 杨洪吉, 邓绍平, 等. 剩余肝体积不足的晚期肝泡型包虫外科治疗进展. 中国普通外科杂志, 2021, 30(1): 98-104.
5. 张宇. ALPPS的衍生术式与评价. 中国普外基础与临床杂志, 2016, 23(1): 9-13.
6. Kim D, Cornman-Homonoff J, Madoff DC. Preparing for liver surgery with “Alphabet Soup”: PVE, ALPPS, TAE-PVE, LVD and RL. Hepatobiliary Surg Nutr, 2020, 9(2): 136-151.
7. 李富贵, 严律南, 李波, 等. 中国成人标准肝体积评估公式的临床研究. 四川大学学报(医学版), 2009, 40(2): 302-306.
8. Ito T, Igarashi H, Jensen RT. Therapy of metastatic pancreatic neuroendocrine tumors (pNETs): recent insights and advances. J Gastroenterol, 2012, 47(9): 941-960.
9. Andreasi V, Muffatti F, Guarneri G, et al. Surgical principles in the management of pancreatic neuroendocrine neoplasms. Curr Treat Options Oncol, 2020, 21(6): 48. doi: 10.1007/s11864-020-00736-w.
10. 吴文铭, 陈洁, 白春梅, 等. 中国胰腺神经内分泌肿瘤诊疗指南(2020). 协和医学杂志, 2021, 12(4): 460-480.
11. Yamao T, Tamura Y, Hayashi H, et al. Novel approach via the round ligament in portal vein embolization. World J Surg, 2021, 45(9): 2878-2885.
12. Chebaro A, Buc E, Durin T, et al. Liver venous deprivation or associating liver partition and portal vein ligation for staged hepatectomy?: a retrospective multicentric study. Ann Surg, 2021, 274(5): 874-880.
13. Schnitzbauer AA, Lang SA, Goessmann H, et al. Right portal vein ligation combined with in situ splitting induces rapid left lateral liver lobe hypertrophy enabling 2-staged extended right hepatic resection in small-for-size settings. Ann Surg, 2012, 255(3): 405-414.
14. Hwang S, Lee SG, Ko GY, et al. Sequential preoperative ipsilateral hepatic vein embolization after portal vein embolization to induce further liver regeneration in patients with hepatobiliary malignancy. Ann Surg, 2009, 249(4): 608-616.
15. Guiu B, Quenet F, Panaro F, et al. Liver venous deprivation versus portal vein embolization before major hepatectomy: future liver remnant volumetric and functional changes. Hepatobiliary Surg Nutr, 2020, 9(5): 564-576.
16. Guiu B, Quenet F, Escal L, et al. Extended liver venous deprivation before major hepatectomy induces marked and very rapid increase in future liver remnant function. Eur Radiol, 2017, 27(8): 3343-3352.
17. Deshayes E, Schadde E, Piron L, et al. Extended liver venous deprivation leads to a higher increase in liver function that ALPPS in early assessment: a comment to “Sparrelid, E. et al. dynamic evaluation of liver volume and function in associating liver partition and portal vein ligation for staged hepatectomy. Journal of Gastrointestinal Surgery (2017)”. J Gastrointest Surg, 2017, 21(10): 1754-1755.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Laparoscopic hepatic vein deprivation

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