Liver Venous Deprivation (LVD) or Associating ...
Document type :
Compte-rendu et recension critique d'ouvrage
PMID :
Permalink :
Title :
Liver Venous Deprivation (LVD) or Associating Liver Partition and Portal Vein Ligation for Staged Hepatectomy (ALPPS)?: A Retrospective Multicentric Study
Author(s) :
Chebaro, Alexandre [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Buc, Emmanuel [Auteur]
CHU Estaing [Clermont-Ferrand]
CHU Clermont-Ferrand
Durin, Thibault [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Chiche, Laurence [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Brustia, Raffaele [Auteur]
CHU Henri Mondor [Créteil]
Didier, Alexandre [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Pruvot, François-René [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Kitano, Yuki [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Kumamoto University
Muscari, Fabrice [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Lecolle, Katia [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Sulpice, Laurent [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Université de Rennes [UR]
Sonmez, Ercin [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Bougard, Marie [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Université de Rennes [UR]
Amrani, Mehdi El [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Sommacale, Daniele [Auteur]
CHU Henri Mondor [Créteil]
Maulat, Charlotte [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Ayav, Ahmet [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Adam, René [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Laurent, Christophe [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Truant, Stéphanie [Auteur correspondant]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Buc, Emmanuel [Auteur]
CHU Estaing [Clermont-Ferrand]
CHU Clermont-Ferrand
Durin, Thibault [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Chiche, Laurence [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Brustia, Raffaele [Auteur]
CHU Henri Mondor [Créteil]
Didier, Alexandre [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Pruvot, François-René [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Kitano, Yuki [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Kumamoto University
Muscari, Fabrice [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Lecolle, Katia [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Sulpice, Laurent [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Université de Rennes [UR]
Sonmez, Ercin [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Bougard, Marie [Auteur]
Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Pontchaillou]
Université de Rennes [UR]
Amrani, Mehdi El [Auteur]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Sommacale, Daniele [Auteur]
CHU Henri Mondor [Créteil]
Maulat, Charlotte [Auteur]
Centre Hospitalier Universitaire de Toulouse [CHU Toulouse]
Ayav, Ahmet [Auteur]
Centre Hospitalier Régional Universitaire de Nancy [CHRU Nancy]
Adam, René [Auteur]
Hôpital Paul Brousse
Université Paris-Saclay
Laurent, Christophe [Auteur]
Centre Hospitalier Universitaire de Bordeaux [CHU Bordeaux]
Truant, Stéphanie [Auteur correspondant]
Centre Hospitalier Régional Universitaire [CHU Lille] [CHRU Lille]
Hétérogénéité, Plasticité et Résistance aux Thérapies des Cancers = Cancer Heterogeneity, Plasticity and Resistance to Therapies - UMR 9020 - U 1277 [CANTHER]
Journal title :
Annals of Surgery
Pages :
874-880
Publisher :
Lippincott, Williams & Wilkins
Publication date :
2021-07-29
ISSN :
0003-4932
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
OBJECTIVE: To compare two techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein (PVE) and hepatic vein embolization (HVE); namely liver venous deprivation ...
Show more >OBJECTIVE: To compare two techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein (PVE) and hepatic vein embolization (HVE); namely liver venous deprivation (LVD), and ALPPS. SUMMARY BACKGROUND DATA: Recent advances in chemotherapy and surgical techniques have widened indications for extended hepatectomy, before which remnant liver augmentation is mandatory. ALPPS and LVD typically show higher hypertrophy rates than PVE, but their respective places in patient management remain unclear. METHODS: All consecutive ALPPS and LVD procedures performed in eight French centers between 2011 and 2020 were included. The main endpoint was the successful resection rate (resection rate without 90-day mortality) analyzed according to an intention-to-treat principle. Secondary endpoints were hypertrophy rates, intra- and post-operative outcomes. RESULTS: Among 209 patients, 124 had LVD 37 [13,1015] days before surgery, while 85 underwent ALPPS with an inter-stages period of 10 [6, 69] days. ALPPS was mostly-performed for colorectal liver metastases (CRLM), LVD for CRLM and perihilar cholangiocarcinoma. Hypertrophy was faster for ALPPS. Successful resection rates were 72.6% for LVD ± rescue ALPPS (n=6) versus 90.6% for ALPPS (p<0.001). Operative duration, blood losses and length-of-stay were lower for LVD, while 90-day major complications and mortality were comparable. Results were globally unchanged for CRLM patients, or after excluding the early 2 years of experience (learning-curve effect). CONCLUSIONS: This study is the first one comparing LVD versus ALPPS in the largest cohort so far. Despite its retrospective design, it yields original results that may serve as the basis for a prospective study.Show less >
Show more >OBJECTIVE: To compare two techniques of remnant liver hypertrophy in candidates for extended hepatectomy: radiological simultaneous portal vein (PVE) and hepatic vein embolization (HVE); namely liver venous deprivation (LVD), and ALPPS. SUMMARY BACKGROUND DATA: Recent advances in chemotherapy and surgical techniques have widened indications for extended hepatectomy, before which remnant liver augmentation is mandatory. ALPPS and LVD typically show higher hypertrophy rates than PVE, but their respective places in patient management remain unclear. METHODS: All consecutive ALPPS and LVD procedures performed in eight French centers between 2011 and 2020 were included. The main endpoint was the successful resection rate (resection rate without 90-day mortality) analyzed according to an intention-to-treat principle. Secondary endpoints were hypertrophy rates, intra- and post-operative outcomes. RESULTS: Among 209 patients, 124 had LVD 37 [13,1015] days before surgery, while 85 underwent ALPPS with an inter-stages period of 10 [6, 69] days. ALPPS was mostly-performed for colorectal liver metastases (CRLM), LVD for CRLM and perihilar cholangiocarcinoma. Hypertrophy was faster for ALPPS. Successful resection rates were 72.6% for LVD ± rescue ALPPS (n=6) versus 90.6% for ALPPS (p<0.001). Operative duration, blood losses and length-of-stay were lower for LVD, while 90-day major complications and mortality were comparable. Results were globally unchanged for CRLM patients, or after excluding the early 2 years of experience (learning-curve effect). CONCLUSIONS: This study is the first one comparing LVD versus ALPPS in the largest cohort so far. Despite its retrospective design, it yields original results that may serve as the basis for a prospective study.Show less >
Language :
Anglais
Popular science :
Non
Source :
Submission date :
2024-02-17T04:20:38Z