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Portal vein embolization for liver regeneration followed by staged hepatectomy for cholangiocarcinoma
. Lansdale: HAYES, Inc.. Healthcare Technology Brief Publication Dates. 2011
Cholangiocarcinoma (CCA) is a primary malignant tumor originating from epithelial cells lining the intra- and extrahepatic biliary trees. Common to the majority of patients with CCA is the finding of advanced disease at presentation. CCAs are usually slow growing, cause bile duct obstruction, and do not metastasize early. They affect both men and women, with most patients > 65 years of age. CCA is a relatively rare cancer, with an annual incidence of 1 to 2 cases per 100,000 in the Western world. There is no potentially curative treatment for CCA except radical surgery (hepatectomy). Outcomes after major hepatic resection are linked to volume and function of the portion of the liver that will remain after resection, which is known as the future liver remnant (FLR). Patients without underlying liver disease will tolerate resection of 60% to 70% (FLR, 40% to 30%) of the total liver volume (TLV) without a significant increase of postoperative hepatic failure. In patients with diseased livers this percentage is lower. Lack of adequate FLR may be the primary obstacle to curative resection for a subset of patients. Portal vein embolization (PVE) is a presurgical treatment for patients in anticipation of extensive liver resection with a small FLR volume. PVE is used to increase the volume and function of the FLR before resection. PVE redirects portal blood flow to the intended liver remnant to induce hypertrophy of the nondiseased portion of the liver. The increase in FLR volume following PVE correlates with increased function of the FLR. Liver regeneration usually peaks within the first 2 weeks after PVE.
Subject indexing assigned by CRD
Portal Vein; Humans; Hepatectomy; Embolization, Therapeutic; Cholangiocarcinoma
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HAYES, Inc., 157 S. Broad Street, Suite 200, Lansdale, PA 19446, USA. Tel: 215 855 0615; Fax: 215 855 5218 Email: email@example.com
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