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Journal of Gastrointestinal Surgery

, Volume 23, Issue 5, pp 914–921 | Cite as

Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

  • Yoshihiro InoueEmail author
  • Kensuke Fujii
  • Masatsugu Ishii
  • Syuji Kagota
  • Atsushi Tomioka
  • Hiroki Hamamoto
  • Wataru Osumi
  • Yusuke Tsuchimoto
  • Shinsuke Masubuchi
  • Masashi Yamamoto
  • Akira Asai
  • Koji Komeda
  • Tetsunosuke Shimizu
  • Mitsuhiro Asakuma
  • Shinya Fukunishi
  • Fumitoshi Hirokawa
  • Yoshihumi Narumi
  • Kazuhide Higuchi
  • Kazuhisa Uchiyama
Original Article
  • 87 Downloads

Abstract

Background

Post-hepatectomy liver regeneration is of great interest to liver surgeons, and understanding the process of regeneration could contribute to increasing the safety of hepatectomies and improving prognoses.

Methods

Five hundred thirty-eight patients who underwent hepatectomy were retrospectively analyzed. Postoperative outcomes were evaluated, with a focus on the effects of portal vein resection and resected liver volume on remnant liver regeneration in patients with liver tumors. Remnant liver volumes (RLVs) and laboratory data were measured postoperatively using multidetector computed tomography on day 7 and months 1, 2, 5, 12, and 24 after the operation.

Results

Liver regeneration speed peaked at 1 week postoperatively and gradually decreased. Regeneration with large resections was longer than that with small resections, with the remnant liver regeneration rate being significantly lower in the former at all time points. Remnant liver regeneration plateaued around 5 months postoperatively, when regeneration is almost complete. Up to 1 month postoperatively, laboratory data were significantly worse when more portal veins was resected. After 2 months postoperatively, these data recovered to near normal levels.

Conclusion

The speed and rate of remnant liver regeneration primarily showed a strong correlation with the number of resected portal veins and the amount of removed liver parenchyma. The larger the resection ratio, the longer it took the liver to regenerate. We confirmed that recovery of the liver’s functional aspects accompanies recovery of the RLV.

Keywords

Volumetric regeneration Functional regeneration Liver regeneration speed Liver regeneration rate Remnant liver Hepatectomy 

Abbreviations

RLV

remnant liver volume

MDCT

multidetector computed tomography

3D

three-dimensional

CT

computed tomography

BMI

body mass index

PT

prothrombin time

ICG-R15

indocyanine green retention rate at 15 min

TLV

total liver volume

PHLF

post-hepatectomy liver failure

OR

odds ratio

CI

confidence interval

Notes

Author Contributions

YI conceived the study and design, was involved in patient care, and drafted the manuscript. KF, MI, SK, AT, HH, WO, YT, SM, MY, AA, KK, TS, MA, SF, FH, YN, KH, and KU were involved in the creation of the study concept and design, patient care, and drafting of the manuscript. All authors have read and approved the final version of the manuscript.

Funding

This work was supported by the Mitsui Life Social Welfare Foundation.

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Copyright information

© The Society for Surgery of the Alimentary Tract 2018

Authors and Affiliations

  • Yoshihiro Inoue
    • 1
    Email author
  • Kensuke Fujii
    • 1
  • Masatsugu Ishii
    • 1
  • Syuji Kagota
    • 1
  • Atsushi Tomioka
    • 1
  • Hiroki Hamamoto
    • 1
  • Wataru Osumi
    • 1
  • Yusuke Tsuchimoto
    • 2
  • Shinsuke Masubuchi
    • 1
  • Masashi Yamamoto
    • 1
  • Akira Asai
    • 2
  • Koji Komeda
    • 1
  • Tetsunosuke Shimizu
    • 1
  • Mitsuhiro Asakuma
    • 1
  • Shinya Fukunishi
    • 2
  • Fumitoshi Hirokawa
    • 1
  • Yoshihumi Narumi
    • 3
  • Kazuhide Higuchi
    • 2
  • Kazuhisa Uchiyama
    • 1
  1. 1.Department of General and Gastroenterological SurgeryOsaka Medical College HospitalTakatsuki CityJapan
  2. 2.Second Department of Internal MedicineOsaka Medical College HospitalTakatsuki CityJapan
  3. 3.Department of RadiologyOsaka Medical College HospitalTakatsuki CityJapan

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