Techniken zur Induktion einer segmentalen Hyperplasie der Leber. Ist die präoperative Pfortaderast-Embolisation der Pfortaderast-Ligatur vorzuziehen?

Abstract

Background: At present, extensive hepatic resection represents the most established treatment for malignancies of the liver. Posthepatectomy liver failure is one of the most serious complications. It is unclear, whether portal vein branch ligation or embolisation represents the more favorable procedure in terms of efficiency to induce a hypertrophy of the future remnant liver volume. Material and Methods: 30 mini pigs underwent surgery. In portal vein branch ligation group(PBL, n =13) and portal vein branch embolisation group (PVE, n = 11), 75% of the liver volume was excluded from direct portal inflow. 6 animals underwent sham operations (SO). To assess the hypertrophy, weight of the non-occluded liver lobes were measured 4 weeks postoperatively. Results: Superior hypertrophy after 4 weeks was observed in the PVE-group compared to the PBL-group. In contrast to the other groups elevation of AST, ALT and GLDH-levels were much higher in the PBL-group. Conclusion: PVE is represents the more effective technique in terms of inducing hypertrophy of the future remnant liver.