Portal vein embolization with N-butyl-cyanoacrylate improves liver hypertrophy compared to microparticles – A Swedish multicenter cohort study
Dennis Björk,
Martin Delle,
Fredrik Holmquist,
Kristina Hasselgren,
Per Sandström,
Gert Lindell,
Ernesto Sparrelid,
Bergthor Björnsson
Affiliations
Dennis Björk
Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Martin Delle
Department of Radiology, Karolinska Universitetssjukhuset, Huddinge and CLINTEC (Department of Clinical Science, Intervention and Technology), Karolinska University, Sweden
Fredrik Holmquist
Department of Medical Imaging and Physiology, Skåne University Hospital Comprehensive Cancer Center, Clinical Sciences Lund, Faculty of Medicine, Lund University, Lund, Sweden
Kristina Hasselgren
Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Per Sandström
Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden
Gert Lindell
Department of Surgery, Skåne University Hospital Comprehensive Cancer Center, Lund University, Lund, Sweden
Ernesto Sparrelid
Division of Surgery, Department of Clinical Science, Intervention and Technology, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden
Bergthor Björnsson
Department of Surgery, Linköping University Hospital and Department of Biomedical and Clinical Sciences, Linköping University, Linköping, Sweden; Corresponding author. Department of Surgery, Linköping University Hospital, S-581 85, Linköping, Sweden.
Background: An adequate future liver remnant (FLR) is fundamental for major liver resections. To achieve sufficient FLR, portal vein embolization (PVE) may be used. The most effective material for PVE has yet to be determined. The aim of this study was to investigate the differences in FLR growth between n-butyl-cyanoacrylate glue (NBCA) and microparticles. Material/methodsa: retrospective study was performed at three Swedish hepatobiliary centers and included patients who underwent PVE 2013–2021. Electronic medical records were reviewed, and procedure-related data were collected. Data were analyzed with respect to embolizing material. Results: A total of 265 patients were included: 160 in the NBCA group and 105 in the microparticle group. The NBCA group had a higher degree of hypertrophy (12.1 vs. 9.4 % points, p = 0.003) and a higher resection rate (68 vs. 59 %, p = 0.01) than the microparticle group. Procedure-related data all indicated the superiority of NBCA. No difference in inducing hypertrophy was observed when comparing patients who received chemotherapy before PVE with those who received chemotherapy before and after PVE within the NBCA group. Discussion/conclusion: This retrospective multicenter study supports the superiority of NBCA compared to microparticles in the setting of PVE. Chemotherapy after PVE does not seem to negatively affect hypertrophy.
