Increase in the Serum Bile Acid Level Predicts the Effective Hypertrophy of the Nonembolized Hepatic Lobe After Right Portal Vein Embolization

• Published in: World journal of surgery Vol. 33; no. 9; pp. 1933 - 1940
• Main Authors: Hayashi, Hiromitsu, Beppu, Toru, Sugita, Hiroki, Horino, Kei, Komori, Hiroyuki, Masuda, Toshiro, Okabe, Hirohisa, Takamori, Hiroshi, Baba, Hideo
• Format: Journal Article
• Language: English
• Published: New York Springer-Verlag 01.09.2009; Springer‐Verlag; Springer; Springer Nature B.V
• Subjects: Abdominal Surgery; Aged; Aged, 80 and over; Analysis of Variance; Bile Acid; Bile Acids and Salts - blood; Bile Duct Carcinoma; Biological and medical sciences; Cardiac Surgery; Embolization, Therapeutic - methods; Female; General aspects; General Surgery; Humans; Hypertrophy - pathology; Liver Function Tests; Liver Neoplasms - blood; Liver Neoplasms - diagnostic imaging; Liver Neoplasms - pathology; Liver Neoplasms - therapy; Liver Regeneration; Male; Medical sciences; Medicine; Medicine & Public Health; Middle Aged; Portal Vein; Portal Vein Embolization; Portal Vein Ligation; Prospective Studies; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects); Statistics, Nonparametric; Surgery; Thoracic Surgery; Tomography, X-Ray Computed; Vascular Surgery; Bile Acid; Bile Duct Carcinoma; Liver Regeneration; Portal Vein Embolization; Portal Vein Ligation; Prediction; Right; Instrumentation therapy; Increase; Medicine; Efficiency; Bile acid; Surgery; Clinical biology; Embolization; Hepatic lobe; Portal vein; Predictive factor; Hypertrophy
• ISSN: 0364-2313; 1432-2323
• DOI: 10.1007/s00268-009-0111-6

Background The purpose of the present study was to investigate the clinical association between serum bile acid level changes and liver hypertrophy in portal vein embolization (PVE). Methods In 31 patients, the serum total bile acid level was prospectively measured before and 1, 3, 5, 7, and 14 days after right PVE. Computed tomographic volumetry was performed before and 25.0 ± 3.6 days after PVE. Results Portal vein embolization induced the liver hypertrophy with a median increase in the left lobe volume (ILV) of 165 cm 3 and a median percentage ILV (%ILV) of 29%. Compared with the pretreatment level, the serum bile acid levels significantly increased on day 3 and day 14 after PVE ( p  = 0.017 and p  = 0.003, respectively). In patients with greater hypertrophy after PVE (ILV > 165 cm 3 and %ILV > 30%), the increases in the bile acid level on day 3 were larger than that in those with lesser hypertrophy ( p  = 0.008 and p  = 0.002, respectively). The increase on day 3 positively correlated with the ILV and %ILV ( p  = 0.003 and p  = 0.004, respectively). The serum bile acid levels on day 3, 5, and 7 after PVE increased in patients with %ILV > 30% but not in those with %ILV ≤ 30%. Conclusions Portal vein embolization increases the serum bile acid level in patients with effective liver hypertrophy in the nonembolized lobe. The increase on day 3 is a useful predictor of effective hypertrophy of the nonembolized lobe. Thus, bile acid signaling may be important for liver regeneration post-PVE.