Dealing with an insufficient future liver remnant: Portal vein embolization and two‐stage hepatectomy

Colorectal liver metastases (CLM) are not always resectable at the time of diagnosis. An insufficient future liver remnant is a factor excluding patients from curative intent resection. To deal with this issue, two‐stage hepatectomy was introduced approximately 20 years ago. It is a sequential treat...

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Bibliographic Details
Published in:Journal of surgical oncology 2019-04, Vol.119 (5), p.594-603
Main Authors: Kawaguchi, Yoshikuni, Lillemoe, Heather A., Vauthey, Jean‐Nicolas
Format: Article
Language:English
Subjects:
Antineoplastic Agents - adverse effects
Cancer surgery
Chemical and Drug Induced Liver Injury - etiology
colorectal liver metastasis
Colorectal Neoplasms - pathology
Embolization
Embolization, Therapeutic - methods
future liver remnant
Hepatectomy - methods
Humans
Liver
Liver Neoplasms - secondary
Liver Neoplasms - therapy
Metastasis
Portal Vein
portal vein embolization
two‐stage hepatectomy
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Description
Summary:Colorectal liver metastases (CLM) are not always resectable at the time of diagnosis. An insufficient future liver remnant is a factor excluding patients from curative intent resection. To deal with this issue, two‐stage hepatectomy was introduced approximately 20 years ago. It is a sequential treatment strategy for bilateral CLM, which consists of preoperative chemotherapy, portal vein embolization, and planned first and second liver resections. This study reviews current evidence supporting use of two‐stage hepatectomy.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.25430