Abstract
Background. There is no agreement regarding the preoperative measurement of liver volumes and
the minimal safe size of the liver remnant after extended hepatectomy. Methods. In 20 patients with hepatobiliary malignancy and no underlying chronic liver disease,
volumetric measurements of the liver remnant (segments 2 and 3 ± 1) were obtained
before extended right lobectomy (right trisegmentectomy). The ratios of future liver
remnant to total liver volume were calculated by using a formula based on body surface
area. In 12 patients, response to preoperative right trisectoral portal vein embolization
was evaluated. In 15 patients who underwent the planned resection, preoperative volumes
were correlated with biochemical and clinical outcome parameters. Results. The future liver remnants increased after portal vein embolization (26% versus 36%,
P <.01). Smaller size liver remnants were associated with an increase in postoperative
liver function tests (P <.05) and longer lengths of hospital stay (P <.02). Preliminary data indicates an increase in major complications for liver volumes
≤25% (P =.02). Conclusions. A simple method of measurement provides an assessment of the liver remnant before
resection. It is useful in evaluating response to portal vein embolization and in
predicating the outcome before extended liver resections. (Surgery 2000;127:512–9.)
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Article info
Publication history
Accepted:
December 28,
1999
Footnotes
*Reprint requests: Jean-Nicolas Vauthey, MD, Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Box 106, Houston, TX 77030.
**Surgery 2000;127:512–9
Identification
Copyright
© 2000 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
