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Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy

  • Original Article
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Post-hepatectomy liver regeneration is of great interest to liver surgeons, and understanding the process of regeneration could contribute to increasing the safety of hepatectomies and improving prognoses.

Methods

Five hundred thirty-eight patients who underwent hepatectomy were retrospectively analyzed. Postoperative outcomes were evaluated, with a focus on the effects of portal vein resection and resected liver volume on remnant liver regeneration in patients with liver tumors. Remnant liver volumes (RLVs) and laboratory data were measured postoperatively using multidetector computed tomography on day 7 and months 1, 2, 5, 12, and 24 after the operation.

Results

Liver regeneration speed peaked at 1 week postoperatively and gradually decreased. Regeneration with large resections was longer than that with small resections, with the remnant liver regeneration rate being significantly lower in the former at all time points. Remnant liver regeneration plateaued around 5 months postoperatively, when regeneration is almost complete. Up to 1 month postoperatively, laboratory data were significantly worse when more portal veins was resected. After 2 months postoperatively, these data recovered to near normal levels.

Conclusion

The speed and rate of remnant liver regeneration primarily showed a strong correlation with the number of resected portal veins and the amount of removed liver parenchyma. The larger the resection ratio, the longer it took the liver to regenerate. We confirmed that recovery of the liver’s functional aspects accompanies recovery of the RLV.

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Abbreviations

RLV:

remnant liver volume

MDCT:

multidetector computed tomography

3D:

three-dimensional

CT:

computed tomography

BMI:

body mass index

PT:

prothrombin time

ICG-R15:

indocyanine green retention rate at 15 min

TLV:

total liver volume

PHLF:

post-hepatectomy liver failure

OR:

odds ratio

CI:

confidence interval

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Funding

This work was supported by the Mitsui Life Social Welfare Foundation.

Author information

Authors and Affiliations

  1. Department of General and Gastroenterological Surgery, Osaka Medical College Hospital, 2-7 Daigaku-machi, Takatsuki City, Osaka, 569-8686, Japan

    Yoshihiro Inoue, Kensuke Fujii, Masatsugu Ishii, Syuji Kagota, Atsushi Tomioka, Hiroki Hamamoto, Wataru Osumi, Shinsuke Masubuchi, Masashi Yamamoto, Koji Komeda, Tetsunosuke Shimizu, Mitsuhiro Asakuma, Fumitoshi Hirokawa & Kazuhisa Uchiyama

  2. Second Department of Internal Medicine, Osaka Medical College Hospital, Takatsuki City, Japan

    Yusuke Tsuchimoto, Akira Asai, Shinya Fukunishi & Kazuhide Higuchi

  3. Department of Radiology, Osaka Medical College Hospital, Takatsuki City, Japan

    Yoshihumi Narumi

Authors
  1. Yoshihiro Inoue
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  2. Kensuke Fujii
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  3. Masatsugu Ishii
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  4. Syuji Kagota
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  5. Atsushi Tomioka
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  6. Hiroki Hamamoto
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  7. Wataru Osumi
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  8. Yusuke Tsuchimoto
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  9. Shinsuke Masubuchi
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  10. Masashi Yamamoto
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  11. Akira Asai
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  12. Koji Komeda
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  13. Tetsunosuke Shimizu
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  14. Mitsuhiro Asakuma
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  15. Shinya Fukunishi
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  16. Fumitoshi Hirokawa
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  17. Yoshihumi Narumi
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  18. Kazuhide Higuchi
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  19. Kazuhisa Uchiyama
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Contributions

YI conceived the study and design, was involved in patient care, and drafted the manuscript. KF, MI, SK, AT, HH, WO, YT, SM, MY, AA, KK, TS, MA, SF, FH, YN, KH, and KU were involved in the creation of the study concept and design, patient care, and drafting of the manuscript. All authors have read and approved the final version of the manuscript.

Corresponding author

Correspondence to Yoshihiro Inoue.

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Inoue, Y., Fujii, K., Ishii, M. et al. Volumetric and Functional Regeneration of Remnant Liver after Hepatectomy. J Gastrointest Surg 23, 914–921 (2019). https://doi.org/10.1007/s11605-018-3985-5

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  • DOI: https://doi.org/10.1007/s11605-018-3985-5

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