LiverA systematic review and meta-analysis of portal vein ligation versus portal vein embolization for elective liver resection
Section snippets
Methods
Randomized and case-controlled studies, irrespective of language, country of origin, hospital, blinding, sample size, or publication status, that compared the use of PVL and PVE for elective liver resection were included in this review. The Cochrane Colorectal Cancer Group Controlled Trials Register, the Cochrane Central Register of Controlled Trials in the Cochrane Library, MEDLINE, Embase, and Science Citation Index Expanded were searched for articles published up to January 2014 using the
Results
The strategies of the literature search and the selection of studies are summarized in Fig 1. Nine studies were included in the meta-analysis. Seven studies comparing PVE and PVL and 2 studies comparing PVE with ALPPS procedure met the inclusion criteria.8, 14, 15, 23, 24, 25, 26, 27, 28 All studies were retrospective. The 7 studies involved 218 patients, of whom 89 were in the PVL group and 129 in the PVE group. The quality and characteristics of the included studies are summarized in the Table
Discussion
Despite advances in the multimodality treatment of liver neoplasms and improvements in chemotherapeutic regimens, management of patients with liver neoplasms remains challenging, especially those with potentially inadequate FLR.14, 29, 30 Over the past few years, PVE and more recently PVL have been employed with varying success to achieve adequate FLR with some studies showing PVL to be less efficient24, 25, 30, 31 than PVE, whereas others showed comparable results.15, 23 This meta-analysis
References (45)
- et al.
Update on portal vein embolization: evidence-based outcomes, controversies, and novel strategies
J Vasc Interv Radiol
(2013) - et al.
Analysis of the efficacy of portal vein embolization for patients with extensive liver malignancy and very low future liver remnant volume, including a comparison with the associating liver partition with portal vein ligation for staged hepatectomy approach
J Am Coll Surg
(2013) - et al.
Portal vein embolization stimulates tumour growth in patients with colorectal cancer liver metastases
HPB (Oxford)
(2012) - et al.
A systematic review of two-stage hepatectomy in patients with initially unresectable colorectal liver metastases
HPB (Oxford)
(2013) - et al.
Portal vein embolization vs. portal vein ligation for induction of hypertrophy of the future liver remnant
J Gastrointest Surg
(2002) - et al.
Right portal vein ligation is as efficient as portal vein embolization to induce hypertrophy of the left liver remnant
J Gastrointest Surg
(2008) - et al.
Associating liver partition and portal vein ligation for staged hepatectomy (ALPPS): a new strategy to increase resectability in liver surgery
Int J Surg
(2014) - et al.
Meta-analysis in clinical trials
Control Clin Trials
(1986) - et al.
Comparative study of right portal vein ligation versus embolisation for induction of hypertrophy in two-stage hepatectomy for multiple bilateral colorectal liver metastases
Eur J Surg Oncol
(2012) - et al.
Prolonged chemotherapy impairs liver regeneration after portal vein occlusion - an audit of 26 patients
Eur J Surg Oncol
(2010)