Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

Jan Nilsson; Sam Eriksson; Peter Nørgaard Larsen; Inger Keussen; Susanne Frevert; Gert Lindell; Christian Sturesson

doi:10.1177/2058460115579121

Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

Jan Nilsson, Sam Eriksson, Peter Nørgaard Larsen, Inger Keussen, Susanne Frevert, Gert Lindell, Christian Sturesson

Afdeling for Røntgen og Skanning DIA

Abstract

BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4-6 weeks.

PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process.

MATERIAL AND METHODS: Six patients were treated with concurrent PTBD and PVE under general anesthesia.

RESULTS: Surgical exploration followed the combined procedure after 35 days (range, 28-51 days). The FLR ratio increased from 22% to 32%. Three patients developed cholangitis after the procedure.

CONCLUSION: The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.

Originalsprog	Engelsk
Tidsskrift	Acta Radiologica Open
Vol/bind	4
Udgave nummer	5
Sider (fra-til)	2058460115579121
DOI	https://doi.org/10.1177/2058460115579121
Status	Udgivet - maj 2015

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10.1177/2058460115579121

Citationsformater

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title = "Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer",

abstract = "BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4-6 weeks.PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process.MATERIAL AND METHODS: Six patients were treated with concurrent PTBD and PVE under general anesthesia.RESULTS: Surgical exploration followed the combined procedure after 35 days (range, 28-51 days). The FLR ratio increased from 22\% to 32\%. Three patients developed cholangitis after the procedure.CONCLUSION: The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.",

author = "Jan Nilsson and Sam Eriksson and \{N{\o}rgaard Larsen\}, Peter and Inger Keussen and Susanne Frevert and Gert Lindell and Christian Sturesson",

year = "2015",

month = may,

doi = "10.1177/2058460115579121",

language = "English",

volume = "4",

pages = "2058460115579121",

journal = "Acta Radiologica Open",

issn = "2058-4601",

publisher = "Sage Publications Ltd",

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TY - JOUR

T1 - Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

AU - Nilsson, Jan

AU - Eriksson, Sam

AU - Nørgaard Larsen, Peter

AU - Keussen, Inger

AU - Frevert, Susanne

AU - Lindell, Gert

AU - Sturesson, Christian

PY - 2015/5

Y1 - 2015/5

N2 - BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4-6 weeks.PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process.MATERIAL AND METHODS: Six patients were treated with concurrent PTBD and PVE under general anesthesia.RESULTS: Surgical exploration followed the combined procedure after 35 days (range, 28-51 days). The FLR ratio increased from 22% to 32%. Three patients developed cholangitis after the procedure.CONCLUSION: The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.

AB - BACKGROUND: Patients with perihilar cholangiocarcinoma and gallbladder cancer extending into the hilum often present with jaundice and a small future liver remnant (FLR). If resectable, preoperative biliary drainage and portal vein embolization (PVE) are indicated. Classically, these measures have been performed sequentially, separated by 4-6 weeks.PURPOSE: To report on a new regime where percutaneous transhepatic biliary drainage (PTBD) and PVE are performed simultaneously, shortening the preoperative process.MATERIAL AND METHODS: Six patients were treated with concurrent PTBD and PVE under general anesthesia.RESULTS: Surgical exploration followed the combined procedure after 35 days (range, 28-51 days). The FLR ratio increased from 22% to 32%. Three patients developed cholangitis after the procedure.CONCLUSION: The combined approach of PTBD and PVE seems feasible, but more studies on morbidity are warranted.

U2 - 10.1177/2058460115579121

DO - 10.1177/2058460115579121

M3 - Journal article

C2 - 25992300

SN - 2058-4601

VL - 4

SP - 2058460115579121

JO - Acta Radiologica Open

JF - Acta Radiologica Open

IS - 5

ER -

Concurrent biliary drainage and portal vein embolization in preparation for extended hepatectomy in patients with biliary cancer

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