liver resection, elective
Conditions
Interventions
Group 1: Single-arm study: patients for open liver resection both with and without preoperative interventional pretreatment by partial portal vein embolization left/right. In patients with preoperativ
Sponsors
Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie
Eligibility
Sex/Gender
All
Age
18 Years to No maximum
Inclusion criteria
Inclusion criteria: - Indication for elective, open liver resection, in each case with or without previous interventional portal vein embolization - ASA I-III - Capacity to consent and legal capacity of the patient
Exclusion criteria
Exclusion criteria: - Vascular resection and reconstruction of the V. portae or A. hepatica - Previous vascular resection and reconstruction of the V. portae or A. hepatica - Previous major liver resections - Prior anatomic liver resection of at least one segment - Status after liver transplantation - Portal vein thrombosis - Transjugular intrahepatic portosystemic shunt (TIPSS) - Liver cirrhosis CHILD B or C - Status after splenic artery ligation - Status after splenectomy - Heart failure >NYHA II - Status after SIRT and TACE - Pregnancy - Breastfeeding - Severe pAVK - Speech problems or impaired mental status
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Difference of portal vein pressure before and 20 minutes after resection | — |
Secondary
| Measure | Time frame |
|---|---|
| - Intraoperative portal vein pressure before resection - Intraoperative portal vein pressure 5 and 20 minutes after liver resection - Pre- and postinterventional portal vein pressure in case of preoperative portal vein embolization - Difference of portal vein pressure between intraoperative portal vein pressure before and 5 minutes after liver resection - Pre-interventional, post-interventional portal vein pressure and the analogous pressure difference in the portal vein system after partial portal vein embolization, if preoperative portal vein embolization is performed - Intraoperative portal vein pressure before parenchymal dissection in the case of a modified ALPPS/in situ split with preoperative PVE already performed - Intraoperative portal vein pressure before portal vein ligation and parenchymal dissection for ALPPS/in situ split - Intraoperative portal pressure 5 and 20 minutes after removal of hemihepatectomy specimen as part of completion surgery for ALPPS/in situ split surgery - Intraoperative portal vein pressure 5 and 20 minutes after parenchymal dissection and portal vein ligation during ALPPS/in-situ split - Intraoperative portal vein pressure 5 and 20 minutes after parenchymal dissection and already preoperatively performed PVE in case of modified ALPPS/in-situ split - Intraoperative portal vein flow before liver resection - Intraoperative portal vein flow 5 and 20 minutes after liver resection - Intraoperative hepatic artery flow before liver resection - Intraoperative hepatic artery flow 5 and 20 minutes after liver resection - Histopathology of liver parenchyma based on resected tissue and correlation to hypertrophy and liver failure - Histology of liver parenchyma on the side without portal vein embolization in lateral side comparison to the parenchyma on the side with portal vein embolization. - Postoperative morbidity (especially ascites and biliary leakage; within hospital length of stay up to 3 months postope | — |
Countries
Germany
Contacts
Public ContactCarina Riediger-Schweipert
Klinik und Poliklinik für Viszeral-, Thorax- und Gefäßchirurgie am Universitätsklinikum Carl Gustav Carus Dresden
Outcome results
None listed