关键词: 肝静脉, 门静脉, 栓塞, 治疗性, 结直肠癌肝转移, 转化治疗

Abstract:

Combined hepatic and portal vein embolization induce fast hypertrophy of future liver remnant: new strategy of conversion therapy for initially unresectable colorectal liver metastases        WANG Xiao-ying, QU Xu-dong，XU Jian-min，et al. Zhongshan Hospital, Fudan University, Shanghai 200032, China   
Corresponding author：WANG Xiao-ying,E-mail:xiaoyingwang@fudan.edu.cn    
WANG Xiao-ying, QU Xu-dong and XU Jian-min are the first authors who contributed equally to the article.
Abstract    Objective    To assess the safety and efficacy of combined hepatic and portal vein embolization（HVE+PVE）to induce hypertrophy of future liver remnant（FLR），and improvement 
of conversion therapy for initially unresectable colorectal liver metastases（CRLM）.Methods    The clinical data of 3 cases with initially unresectable CRLM underwent conversion therapy by HVE+PVE after systemic therapy between December，2020 and November，2021 at Zhongshan Hospital，Fudan University were analyzed retrospectively. These 3 cases showed partial response after systemic chemotherapy and targeted therapy，however，FLR was insufficient for extended resection. Results    HVE+PVE was safely performed in 3 cases without complication.At a mean of 18.6 days after HVE+PVE，FLR increased 32.8 %，from 423.6 mL to 561 mL，FLR/SLV increased from 33.5% to 43.8%.3 cases underwent extended hepatectomy at a mean of 23 days after HVE+PVE.Mean operative blood loss was 333.3 mL，and blood transfusion rate was 0.The R0 resection rate was 100%.There was no major postoperative complication（＞Clavien-Dindo gradeⅢ），liver failure and 90 d mortality.The mean hospital stay was 11.3 days.Conclusion    HVE+PVE is a simple，safe and minimally invasive interventional technique，which induces fast hypertrophy of FLR.Combination of HVE+PVE and systemic therapy will increase the conversion rate of initially unresectable CRLM.

Key words: hepatic vein, portal vein, embolization, colorectal liver metastases, conversion therapy