Portal Vein Embolization Followed by Liver Resection versus Liver Resection Alone: a Comparison of Liver Regeneration Dynamics.

Background/aims: Portal vein embolization (PVE) is an accepted procedure, which, by redirecting portal vein flow toward specific hepatic segments, is able to pre-operatively increase the volume of the future liver remnant (FLR). The consequent reduction of liver dysfunction risk enables to extend the number of pa tients eligible for major hepatic resection. This study aims at comparing liver regeneration dynamics and long-term volumetric recovery after major hepatic re section preceded by PVE versus major hepatic resec tion not preceded by PVE.

Methodology: Data from 24 consecutive patients who underwent PVE prior to major hepatic resection were collected and compared to 24 consecutive patients who underwent major hepatic resection, but on whom PVE was not performed.

Results: A significant growth of the FLR was observed after PVE. The liver remnant underwent a further regeneration burst after resection, with long-term volumetric recovery rates around 85% of the estimated total liver volume, similar to those observed for the control group and to those previously documented in the relevant literature.

Conclusion: PVE gives a first impulse to liver regeneration before liver resection without compromising further regeneration after resection, resulting in long-term volumetric recovery rates similar to those known for regeneration after liver resection without prior PVE.