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Invited Critique |

Is Waiting Longer Better?  Comment on “Kinetics of Liver Volume Changes in the First Year After Portal Vein Embolization”

Kenzo Hirose, MD
Arch Surg. 2010;145(4):354-355. doi:10.1001/archsurg.2010.29.
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Preoperative PVE has become a well-established maneuver to reduce the risk of postoperative hepatic insufficiency following major hepatectomy. In the present study, Corrêa et al have shown in 10 patients who underwent PVE but did not undergo resection that the atrophy-hypertrophy complex that occurs following PVE continues for up to 1 year after embolization. Few long-term data exist for rates of hypertrophy at 1 year following PVE because most of these patients undergo resection within 4 to 8 weeks. Previous data have suggested that most hypertrophy of the future liver remnant will have occurred by 21 days after PVE.1 Longer-term data among patients who were not resected showed further hypertrophy beyond 2 months, although follow-up was very heterogeneous. In the present study, 8 patients were followed up for 210 days and 5 patients were followed up for 1 year, with significant growth observed up to 1 year.

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