Liver Venous Deprivation
Conditions
Brief summary
The main obstacle to achieving R0 resection in future liver remnant（FLR） deficient liver cancer is the inability to retain sufficient FLR to avoid postoperative liver failure. From the initial portal vein embolization(PVE), to the later ALPPS, this problem has been solved to some extent. However, both have their own shortcomings. The effect of liver hyperplasia after PVE is poor and the waiting time is long. The incidence of complication and mortality after ALPPS is always the focus of controversy. In recent years, LVD has emerged, combining PVE and HVE in the one operation. This topic will conduct a clinical controlled study of PVE and LVD.
Interventions
PROCEDUREPVE
Portal vein embolization (PVE) mainly embolizes the portal vein of the resected liver lobe, causing the non-tumor lobe to proliferate, and after tumor lobectomy, the volume of the non-tumor lobe proliferates so that patients with hepatocellular carcinoma that could not be directly surgically resected are given the opportunity to be surgically resected
PROCEDURELVD
Combining PVE and Hepatic Vein Embolization (HVE) in the same procedure
Sponsors
Anhui Provincial Hospital
Study design
Allocation
NON_RANDOMIZED
Intervention model
PARALLEL
Primary purpose
TREATMENT
Masking
DOUBLE (Subject, Caregiver)
Intervention model description
Partial hepatectomy+PVE Partial hepatectomy+LVD
Eligibility
Sex/Gender
ALL
Age
18 Years to 75 Years
Healthy volunteers
No
Inclusion criteria
* ① Age 18 to 75 years old, male or female. * hepatocellular liver cancer diagnosed by pathological histology, immunohistochemistry or imaging examination, with large tumor size that cannot be removed in one stage surgery * No distant metastasis of the lesion. * FLR\<20% in patients with normal liver function; FLR\<30% in patients with combined fatty liver and receiving chemotherapy; FLR\<40% in compensated cirrhosis ⑤ Normal function of major organs other than liver-related functions. ⑥ Subjects voluntarily enrolled in this study, signed informed consent, good compliance, and cooperated with follow-up. * Patients who the investigator believes can benefit.
Exclusion criteria
* Withdrawal of consent by the subject. * Having adverse reactions. ③ Failure to receive treatment due to progression. * Death of the patient. * Loss to follow-up. ⑥ Others.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| FLR growth rate | 15days | FLR growth rate between two surgeries |
Countries
China
Outcome results
None listed