What’s the Impact of Hyperbilirubinemia on Future Liver Remnant Hypertrophy?
At the time of percutaneous transhepatic portal vein embolization (PVE), hyperbilirubinemia has no apparent effect on future liver remnant (FLR) hypertrophy, according to a study published in the Journal of Vascular and Interventional Radiology. Grade 3 post-hepatectomy liver failure incidence was also not influenced.
This retrospective study included 87 patients who underwent PVE, using Gelfoam and coils before major hepatectomy between January 2004 and June 2016. Patients were divided into a hyperbilirubinemia (serum total bilirubin level at PVE 5.80 ± 2.44 mg/dL; n = 41) group and a control group (1.09 ± 0.73 mg/dL; n = 46).
Prior to PVE and an average of 18.5 days after PVE, liver volume was measured using computerized tomographic data. Correlation between FLR hypertrophy and total bilirubin were analyzed. FLR hypertrophy and incidence of post-hepatectomy liver failure were compared. Simple regressions were used for univariable analyses whereas multiple regressions were used for multivariable analyses.
Mean FLR volume before PVE was 529 1 cm3 and after was 640.5 cm3. Degree of hypertrophy and percentage increase in future liver remnant (%FLR) were 7.64 ± 4.22 and 21.77 ± 13.34, respectively. There was no significant correlation between FLR hypertrophy and total bilirubin (P > 0.5) and there were no significant difference between FLR hypertrophy in the 2 groups. In 73 patients (83.9%), a planned major hepatectomy was performed. Grade 3 post-hepatectomy liver failure occurred in 6 patients and its incidence was not significantly different between the groups (P = 0.354).
The authors concluded that at the time of PVE, hyperbilirubinemia had no effect of FLR hypertrophy, and that “the incidence of grade 3 post-hepatectomy liver failure is not likely to be influenced, either.”
Jaehyun Yim, MD, Dongho Hyun, MD, Sung Ki Cho, MD, et al. Effect of hyperbilirubinemia on hepatic hypertrophy after portal vein embolization and liver failure after heatectomy in primary biliary malignancy. J Vasc Interv Radiol. 2018; Epub ahead of print. DOI: https://doi.org/10.1016/j.jvir.2018.08.006.