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A systematic review and meta-analysis of liver venous deprivation versus portal vein embolization before hepatectomy: future liver volume, postoperative outcomes, and oncological safety

Introduction: This systematic review aimed to compare liver venous deprivation (LVD) with portal vein embolization (PVE) in terms of future liver volume, postoperative outcomes, and oncological safety before major hepatectomy. Methods: We conducted this systematic review and meta-analysis following...

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Main Authors: Chaouch, Mohamed Ali (Author) , Mazzotta, Alessandro (Author) , da Costa, Adriano Carneiro (Author) , Hussain, Mohammad Iqbal (Author) , Gouader, Amine (Author) , Krimi, Bassem (Author) , Panaro, Fabrizio (Author) , Guiu, Boris (Author) , Soubrane, Olivier (Author) , Oweira, Hani (Author)
Format: Article (Journal)
Language:English
Published: 10 January 2024
In: Frontiers in medicine
Year: 2024, Volume: 10, Pages: 1-11
ISSN:2296-858X
DOI:10.3389/fmed.2023.1334661
Online Access:Verlag, kostenfrei, Volltext: https://doi.org/10.3389/fmed.2023.1334661
Verlag, kostenfrei, Volltext: https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2023.1334661/full
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Author Notes:Mohamed Ali Chaouch, Alessandro Mazzotta, Adriano Carneiro da Costa, Mohammad Iqbal Hussain, Amine Gouader, Bassem Krimi, Fabrizio Panaro, Boris Guiu, Olivier Soubrane, Hani Oweira
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Summary:Introduction: This systematic review aimed to compare liver venous deprivation (LVD) with portal vein embolization (PVE) in terms of future liver volume, postoperative outcomes, and oncological safety before major hepatectomy. Methods: We conducted this systematic review and meta-analysis following the PRISMA guidelines 2020 and AMSTAR 2 guidelines. Comparative articles published before November 2022 were retained. Results: The literature search identified nine eligible comparative studies. They included 557 patients, 207 in the LVD group and 350 in the PVE group. This systematic review and meta-analysis concluded that LVD was associated with higher future liver remnant (FLR) volume after embolization, percentage of FLR hypertrophy, lower failure of resection due to low FLR, faster kinetic growth, higher day 5 prothrombin time, and higher 3 years’ disease-free survival. This study did not find any difference between the LVD and PVE groups in terms of complications related to embolization, FLR percentage of hypertrophy after embolization, failure of resection, 3-month mortality, overall morbidity, major complications, operative time, blood loss, bile leak, ascites, post hepatectomy liver failure, day 5 bilirubin level, hospital stay, and three years’ overall survival. Conclusion: LVD is as feasible and safe as PVE with encouraging results making some selected patients more suitable for surgery, even with a small FLR. Systematic review registration: The review protocol was registered in PROSPERO before conducting the study (CRD42021287628)
Item Description:Gesehen am 05.12.2024
Physical Description:Online Resource
ISSN:2296-858X
DOI:10.3389/fmed.2023.1334661

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