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Invited Critique |

Sex Dimorphism in the Outcome of Preoperative Right Portal Vein Embolization—Invited Critique

Jason K. Sicklick, MD; Frederic Eckhauser, MD
Arch Surg. 2008;143(3):259. doi:10.1001/archsurg.2007.259.
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Yokoyama and colleagues report a possible correlation between sex dimorphism and clinical outcome after PVE in 88 patients, including 42 men and 46 women, each of whom had a carcinoma arising from the gallbladder or the intrahepatic or extrahepatic biliary tract. All 88 patients underwent planned resection of the right lobe of the liver. The authors observed that PVE was associated with higher percentage changes in the liver volume and in the ICG clearance among women than among men, even after adjusting for differences in body size. A similar sex difference was observed in patients who did not undergo preoperative PVE. In addition, the risk of postoperative liver failure after PVE was lower in women than in men. Based on the latter data, which coincidentally were not statistically significant, the authors postulated that the observed findings resulted from the effect of differences in sex hormones and receptors on liver regeneration.

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