The Cross-Sectional Area Ratio of Right-to-Left Portal Vein Predicts the Effect of Preoperative Right Portal Vein Embolization
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. RPVA/LPVA
2.3. Statistical Analysis
3. Results
3.1. Baseline Characteristics of the Patients
3.2. Procedure-Related Characteristics of the Patients
3.3. Surgical Outcomes
3.4. Prognostic Factors for Sufficient ΔFRLV%
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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≤1.2 (N = 30) | >1.2 (N = 35) | p Value | |
---|---|---|---|
Age (mean) | 64.57 | 62.97 | 0.599 |
Age ≥ 65 | 18 (60.0%) | 15 (42.9%) | 0.168 |
Sex (male) | 7 (23.3%) | 10 (28.6%) | 0.632 |
BMI (mean) | 23.73 | 23.4 | 0.712 |
LC (radiology) | 6 (20.0%) | 2 (5.7%) | 0.085 |
HBV (+) | 6 (20.0%) | 6 (17.1%) | 0.767 |
HCV (+) | 3 (10.0%) | 0 (0.0%) | 0.093 |
Serum creatinine (mean) | 0.81 | 0.81 | 0.983 |
Serum AST (mean) | 48.4 | 44.1 | 0.462 |
Serum ALT (mean) | 49.9 | 47.9 | 0.777 |
Serum albumin (mean) | 3.76 | 3.84 | 0.435 |
Serum TB (mean) | 1.06 | 0.93 | 0.302 |
Serum platelet (mean) | 262.33 | 247.17 | 0.578 |
INR (mean) | 1.10 | 1.04 | 0.057 |
Ascites | 2 (6.7%) | 0 (0.0%) | 0.209 |
Disease | |||
HCC | 11 (36.7%) | 8 (22.9%) | 0.222 |
pCCA | 13 (43.3%) | 16 (45.7%) | 0.847 |
GBC | 2 (6.7%) | 3 (8.6%) | 0.574 |
CRLM | 2 (6.7%) | 7 (20.0%) | 0.116 |
Others | 2 (6.7%) | 1 (2.9%) | 0.442 |
Adenocarcinoma | 17 (56.7%) | 27 (77.1%) | 0.078 |
RH (N = 54) | Non-RH (N = 11) | p Value | |
---|---|---|---|
Age (mean) | 63.93 | 62.64 | 0.749 |
Age ≥ 65 | 27 (50.0%) | 6 (54.5%) | 0.783 |
Sex (male) | 16 (29.6%) | 1 (9.1%) | 0.149 |
BMI (mean) | 23.89 | 21.89 | 0.092 |
LC (radiology) | 6 (11.1%) | 2 (18.2%) | 0.408 |
HBV (+) | 9 (16.7%) | 3 (27.3%) | 0.327 |
HCV (+) | 3 (5.6%) | 0 (0.0%) | 0.568 |
Serum creatinine (mean) | 0.79 | 0.92 | 0.072 |
Serum AST (mean) | 46.00 | 46.55 | 0.944 |
Serum ALT (mean) | 49.02 | 47.73 | 0.893 |
Serum albumin (mean) | 3.81 | 3.76 | 0.750 |
Serum TB (mean) | 0.91 | 1.39 | 0.049 |
Serum platelet (mean) | 250.04 | 274.45 | 0.500 |
INR (mean) | 1.06 | 1.14 | 0.044 |
Ascites | 1 (1.9%) | 1 (9.1%) | 0.312 |
Disease | |||
HCC | 15 (27.8%) | 4 (36.4%) | 0.406 |
pCCA | 24 (44.4%) | 5 (45.5%) | 0.603 |
GBC | 3 (5.6%) | 2 (18.2%) | 0.196 |
CRLM | 9 (16.7%) | 0 (0.0%) | 0.166 |
Others | 3 (5.6%) | 0 (0.0%) | 0.568 |
Adenocarcinoma | 37 (68.5%) | 7 (63.6%) | 0.504 |
≤1.2 (N = 30) | >1.2 (N = 35) | p Value | |
---|---|---|---|
Pre-FRLV% (mean) | 42.47% | 35.49% | <0.001 |
Pre-RHLV/LHLV (mean) | 1.43 | 1.93 | <0.001 |
RPVA (π mm2; mean) | 25.12 | 34.39 | <0.001 |
LPVA (π mm2; mean) | 27.83 | 19.91 | <0.001 |
Post-FRLV% (mean) | 51.99% | 50.83% | 0.573 |
ΔFRLV% (mean) | 9.52% | 15.34% | <0.001 |
Operation type | 0.049 | ||
RH | 22 (73.3%) | 32 (91.4%) | |
Non-RH | 8 (26.7%) | 3 (8.6%) |
RH (N = 54) | Non-RH (N = 11) | p Value | |
---|---|---|---|
Pre-FRLV% (mean) | 38.71% | 38.72% | 0.996 |
RPVA (π mm2; mean) | 10.84 | 10.36 | 0.428 |
LPVA (π mm2; mean) | 9.36 | 9.63 | 0.610 |
RPVA/LPVA (mean) | 1.41 | 1.33 | 0.728 |
Post-FRLV% (mean) | 51.84% | 49.00% | 0.295 |
ΔFRLV% (mean) | 13.14% | 9.28% | 0.037 |
≤1.2 (N = 25) | >1.2 (N = 32) | p Value | |
---|---|---|---|
Pringle maneuver | 4 (16.0%) | 3 (9.4%) | 0.360 |
Pringle time | 3.52 | 3.91 | 0.898 |
Major vessel reconstruction | 2 (8.0%) | 5 (15.6%) | 0.327 |
Operation time | 304.26 | 299.47 | 0.869 |
Estimated blood loss | 826.91 | 725.76 | 0.626 |
Posthepatectomy liver failure | 1 (4.5%) | 1 (3.1%) | 0.653 |
CDC ≥ IIIa | 14 (51.9%) | 12 (35.3%) | 0.194 |
R0 resection | 14 (53.8%) | 28 (84.8%) | 0.009 |
Postoperative hospital stay | 16.58 | 16.56 | 0.996 |
Variables | Univariate Analysis | Multivariable Analysis | ||||
---|---|---|---|---|---|---|
HR | 95% CI | p Value | HR | 95% CI | p Value | |
Age ≥ 65 | 0.667 | 0.227–1.961 | 0.461 | |||
Sex (male) | 1.012 | 0.300–3.410 | 0.985 | |||
BMI | 0.949 | 0.818–1.101 | 0.491 | |||
LC (radiology) | 0.195 | 0.041–0.923 | 0.039 | 1.193 | 0.116–12.219 | 0.882 |
HBV (+) | 0.503 | 0.137–1.844 | 0.300 | |||
HCV (+) | 0.189 | 0.016–2.221 | 0.185 | |||
Serum creatinine (mean) | 1.437 | 0.113–18.302 | 0.780 | |||
Serum AST (mean) | 0.992 | 0.970–1.014 | 0.489 | |||
Serum ALT (mean) | 1.007 | 0.987–1.027 | 0.503 | |||
Serum albumin (mean) | 1.196 | 0.323–4.423 | 0.789 | |||
Serum TB (mean) | 1.381 | 0.479–3.981 | 0.551 | |||
Serum platelet (mean) | 0.999 | 0.994–1.004 | 0.643 | |||
INR > 1.1 | 0.287 | 0.094–0.873 | 0.028 | 0.432 | 0.104–1.791 | 0.248 |
Ascites | 0.400 | 0.024–6.746 | 0.525 | |||
Disease | ||||||
HCC | 0.219 | 0.069–0.697 | 0.010 | 0.185 | 0.041–0.828 | 0.027 |
pCCA | 1.571 | 0.525–4.707 | 0.419 | |||
CRLM | 3.789 | 0.440–32.635 | 0.225 | |||
Others | 0.818 | 0.070–9.599 | 0.873 | |||
Adenocarcinoma | 4.950 | 1.569–15.618 | 0.006 | 1.992 | 0.100–39.709 | 0.652 |
RPVA/LPVA > 1.2 | 21.577 | 4.358–106.824 | <0.001 | 23.771 | 4.319–130.811 | <0.001 |
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Jo, Y.; Lee, H.W.; Han, H.-S.; Yoon, Y.-S.; Cho, J.Y. The Cross-Sectional Area Ratio of Right-to-Left Portal Vein Predicts the Effect of Preoperative Right Portal Vein Embolization. Medicina 2024, 60, 1114. https://doi.org/10.3390/medicina60071114
Jo Y, Lee HW, Han H-S, Yoon Y-S, Cho JY. The Cross-Sectional Area Ratio of Right-to-Left Portal Vein Predicts the Effect of Preoperative Right Portal Vein Embolization. Medicina. 2024; 60(7):1114. https://doi.org/10.3390/medicina60071114
Chicago/Turabian StyleJo, Yeongsoo, Hae Won Lee, Ho-Seong Han, Yoo-Seok Yoon, and Jai Young Cho. 2024. "The Cross-Sectional Area Ratio of Right-to-Left Portal Vein Predicts the Effect of Preoperative Right Portal Vein Embolization" Medicina 60, no. 7: 1114. https://doi.org/10.3390/medicina60071114