Clinical and experimental studies on portal vein embolization / Diagnosis of hepatocellular adenoma and focal nodular hyperplasia

The first part of this thesis concerns liver regeneration after portal vein embolization (PVE). The use of PVE over the past 20 years is reviewed and its effect on tumor growth and (postresectional) hypertrophy response discussed. The effects of several portal vein occlusion techniques are evaluated in experimental studies using a rabbit model of PVE. The second part of this thesis deals with two liver tumors, hepatocellular adenoma (HCA) and focal nodular hyperplasia (FNH), which are relatively rare, benign liver tumors. The main focus is on differentiation of these tumors using current imaging modalities

Volumetric and functional recovery of the remnant liver after major liver resection with prior portal vein embolization: recovery after PVE and liver resection

INTRODUCTION: Portal vein embolization is an accepted method to increase the future remnant liver preoperatively. The aim of this study was to assess the effect of preoperative portal vein embolization on liver volume and function 3 months after major liver resection. MATERIALS AND METHODS: This is a retrospective case-control study. Data were collected of patients who underwent portal vein embolization prior to (extended) right hemihepatectomy and of control patients who underwent the same type of resection without prior portal vein embolization. Liver volumes were measured by computed tomography volumetry before portal vein embolization, before liver resection, and 3 months after liver resection. Liver function was assessed by hepatobiliary scintigraphy before and 3 months after liver resection. RESULTS: Ten patients were included in the embolization group and 13 in the control group. Groups were comparable for gender, age, and number of patients with a compromised liver. The mean future remnant liver volume was 33.0 +/- 8.0% prior to portal vein embolization in the embolization group and 45.6 +/- 9.1% in the control group (p 0.05). Remnant liver function increased up to 88.1 +/- 17.4% and 83.3 +/- 14% respectively of the original total liver function (p > 0.05). CONCLUSION: Preoperative portal vein embolization does not negatively influence postoperative liver regeneration assessed 3 months after major liver resectio