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Systemic chemotherapy, which is routinely used before liver resection for colorectal liver metastases (CRLM), can induce parenchymal liver injury, including steatosis, steatohepatitis, and sinusoidal injuries leading to fibrosis. These chemo-induced lesions could decrease the tolerance of liver resection and impair liver regeneration resulting in a higher risk of postoperative complications. We aimed...
Increasing evidence suggests that preoperative PVE itself stimulates tumor growth both in the embolized and nonembolized segments of the liver by altering the blood supply and/or inducing a network of cytokines and growth factors, though the precise mechanism/network has not been fully clarified. This stimulating effect is more obvious in patients with HCC and colorectal liver metastases. Sequential...
In patients scheduled for extended right hemihepatectomy, portal venous embolization (PVE) as an isolated modality may fail to induce an adequate hepatic volume response within a reasonable period of time. In particular, patients with very small future liver remnant volumes, compromised hepatic parenchyma or comorbidity, and impaired liver regeneration capacity may be initially considered unsuitable...
Portal vein embolization (PVE) is increasingly used to increase the volume and function of the liver that will remain after resection of large and multiple liver tumors. This chapter examines the strong, extensive evidence supporting the use of preoperative PVE prior to major hepatic resection based on analysis of the future liver remnant (FLR), or liver that will remain after resection. Specifically,...
Portal vein embolization (PVE) has been widely used to increase safety of major hepatectomy for patients with hepatobiliary malignancies, and advantages of PVE have been reported. Although procedure-related morbidity is quite low, further technical development is necessary to reduce complications and to estimate the functional and volumetric changes of the hepatic lobe after PVE. Moreover, the indication...
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