Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma
Purpose: In the current situation of an increasing older adult population with perihilar cholangiocarcinoma (PHCC), the benefits and risks of surgical treatment of PHCC in older people remain controversial. Portal vein embolization (PVE) is a useful preoperative procedure to improve hepatic reserve...
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| Format: | Article |
| Language: | English |
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Elsevier
2025-02-01
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| Series: | Asian Journal of Surgery |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S1015958424024850 |
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| author | Shinichi Nakanuma Takahiro Ogi Hiroaki Sugita Ryosuke Gabata Tomokazu Tokoro Ryohei Takei Kaichiro Kato Satoshi Takada Mitsuyoshi Okazaki Isamu Makino Shintaro Yagi |
| author_facet | Shinichi Nakanuma Takahiro Ogi Hiroaki Sugita Ryosuke Gabata Tomokazu Tokoro Ryohei Takei Kaichiro Kato Satoshi Takada Mitsuyoshi Okazaki Isamu Makino Shintaro Yagi |
| author_sort | Shinichi Nakanuma |
| collection | DOAJ |
| description | Purpose: In the current situation of an increasing older adult population with perihilar cholangiocarcinoma (PHCC), the benefits and risks of surgical treatment of PHCC in older people remain controversial. Portal vein embolization (PVE) is a useful preoperative procedure to improve hepatic reserve in the future remnant liver (FRL) and avoid postoperative liver failure after extended hepatectomy for PHCC. This study aimed to evaluate the influence of aging on PVE. Methods: We enrolled 25 patients who underwent right hepatectomy with percutaneous transhepatic PVE. Participants aged <70 years (n = 13) and ≥70 years (n = 12) were compared; correlation coefficients were evaluated using all cases. The FRL volume/total liver volume (FRLV/TLV) ratio and the indocyanine green (ICG) clearance rate (ICG-K) fraction of FRL to total liver (ICG-Krem) were analyzed as FRL hepatic reserves. Results: FRLV/TLV ratio increased after PVE in <70 years and ≥70 years groups (p = 0.002 and p = 0.013, respectively). The change in ICG-K values from before to after PVE varied between both groups (p = 0.040). The ICG-Krem value after PVE increased only in the <70 years group (p = 0.009). A review of all cases showed a negative correlation between the change (after - before PVE) in the ICG-K and ICG-Krem values and age (r = −0.4827, p = 0.0145 and r = −0.4328, p = 0.0306, respectively). Conclusions: This study showed aging suppresses hepatic reserve improvement in the FRL, particularly in ICG clearance after PVE in PHCC cases. |
| format | Article |
| id | doaj-art-037149ca7d8c44d6a506e3332770187c |
| institution | Kabale University |
| issn | 1015-9584 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Asian Journal of Surgery |
| spelling | doaj-art-037149ca7d8c44d6a506e3332770187c2025-01-30T05:13:44ZengElsevierAsian Journal of Surgery1015-95842025-02-0148210101015Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinomaShinichi Nakanuma0Takahiro Ogi1Hiroaki Sugita2Ryosuke Gabata3Tomokazu Tokoro4Ryohei Takei5Kaichiro Kato6Satoshi Takada7Mitsuyoshi Okazaki8Isamu Makino9Shintaro Yagi10Department of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, Japan; Corresponding author.Department of Radiology, Kanazawa University Graduate School of Medical Sciences, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanDepartment of Hepato-Biliary-Pancreatic Surgery and Transplantation, Kanazawa University, 13-1 Takara-machi, Kanazawa, Ishikawa, 920-8641, JapanPurpose: In the current situation of an increasing older adult population with perihilar cholangiocarcinoma (PHCC), the benefits and risks of surgical treatment of PHCC in older people remain controversial. Portal vein embolization (PVE) is a useful preoperative procedure to improve hepatic reserve in the future remnant liver (FRL) and avoid postoperative liver failure after extended hepatectomy for PHCC. This study aimed to evaluate the influence of aging on PVE. Methods: We enrolled 25 patients who underwent right hepatectomy with percutaneous transhepatic PVE. Participants aged <70 years (n = 13) and ≥70 years (n = 12) were compared; correlation coefficients were evaluated using all cases. The FRL volume/total liver volume (FRLV/TLV) ratio and the indocyanine green (ICG) clearance rate (ICG-K) fraction of FRL to total liver (ICG-Krem) were analyzed as FRL hepatic reserves. Results: FRLV/TLV ratio increased after PVE in <70 years and ≥70 years groups (p = 0.002 and p = 0.013, respectively). The change in ICG-K values from before to after PVE varied between both groups (p = 0.040). The ICG-Krem value after PVE increased only in the <70 years group (p = 0.009). A review of all cases showed a negative correlation between the change (after - before PVE) in the ICG-K and ICG-Krem values and age (r = −0.4827, p = 0.0145 and r = −0.4328, p = 0.0306, respectively). Conclusions: This study showed aging suppresses hepatic reserve improvement in the FRL, particularly in ICG clearance after PVE in PHCC cases.http://www.sciencedirect.com/science/article/pii/S1015958424024850Hepatic reservePortal vein embolizationHepatectomyAgingElderlyPerihilar cholangiocarcinoma |
| spellingShingle | Shinichi Nakanuma Takahiro Ogi Hiroaki Sugita Ryosuke Gabata Tomokazu Tokoro Ryohei Takei Kaichiro Kato Satoshi Takada Mitsuyoshi Okazaki Isamu Makino Shintaro Yagi Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma Asian Journal of Surgery Hepatic reserve Portal vein embolization Hepatectomy Aging Elderly Perihilar cholangiocarcinoma |
| title | Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| title_full | Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| title_fullStr | Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| title_full_unstemmed | Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| title_short | Impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| title_sort | impact of aging on hepatic reserve after preoperative portal vein embolization in hepatectomy for perihilar cholangiocarcinoma |
| topic | Hepatic reserve Portal vein embolization Hepatectomy Aging Elderly Perihilar cholangiocarcinoma |
| url | http://www.sciencedirect.com/science/article/pii/S1015958424024850 |
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