Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy
BackgroundFor patients with hilar cholangiocarcinoma (HC) undergoing hemi-hepatectomy, there are controversies regarding the requirement of, indications for, and timing of preoperative biliary drainage (PBD). Dynamic three-dimensional volume reconstruction could effectively evaluate the regeneration...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2024-04-01
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| Series: | Frontiers in Oncology |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fonc.2024.1375648/full |
| _version_ | 1797201101587480576 |
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| author | Haoyu Zhao Baifeng Li Xiaohang Li Xiangning Lv Tingwei Guo Zongbo Dai Chengshuo Zhang Jialin Zhang |
| author_facet | Haoyu Zhao Baifeng Li Xiaohang Li Xiangning Lv Tingwei Guo Zongbo Dai Chengshuo Zhang Jialin Zhang |
| author_sort | Haoyu Zhao |
| collection | DOAJ |
| description | BackgroundFor patients with hilar cholangiocarcinoma (HC) undergoing hemi-hepatectomy, there are controversies regarding the requirement of, indications for, and timing of preoperative biliary drainage (PBD). Dynamic three-dimensional volume reconstruction could effectively evaluate the regeneration of liver after surgery, which may provide assistance for exploring indications for PBD and optimal preoperative bilirubin value. The purpose of this study was to explore the indications for PBD and the optimal preoperative bilirubin value to improve prognosis for HC patients undergoing hemi-hepatectomy.MethodsWe retrospectively analyzed the data of HC patients who underwent hemi-hepatectomy in the First Affiliated Hospital of China Medical University from 2012 to 2023. The liver regeneration rate was calculated using three-dimensional volume reconstruction. We analyzed the factors affecting the liver regeneration rate and occurrence of postoperative liver insufficiency.ResultsThis study involved 83 patients with HC, which were divided into PBD group (n=36) and non-PBD group (n=47). The preoperative bilirubin level may be an independent risk factor affecting the liver regeneration rate (P=0.014) and postoperative liver insufficiency (P=0.016, odds ratio=1.016, β=0.016, 95% CI=1.003–1.029). For patients whose initial bilirubin level was >200 μmol/L (n=45), PBD resulted in better liver regeneration in the early stage (P=0.006) and reduced the incidence of postoperative liver insufficiency [P=0.012, odds ratio=0.144, 95% confidence interval (CI)=0.031–0.657]. The cut-off value of bilirubin was 103.15 μmol/L based on the liver regeneration rate. Patients with a preoperative bilirubin level of ≤103.15 μmol/L shown a better liver regeneration (P<0.01) and lower incidence of postoperative hepatic insufficiency (P=0.011, odds ratio=0.067, 95% CI=0.008–0.537).ConclusionFor HC patients undergoing hemi-hepatectomy whose initial bilirubin level is >200 μmol/L, PBD may result in better liver regeneration and reduce the incidence of postoperative liver insufficiency. Preoperative bilirubin levels ≤103.15 μmol/L maybe recommended for leading to a better liver regeneration and lower incidence of postoperative hepatic insufficiency. |
| first_indexed | 2024-04-24T07:42:11Z |
| format | Article |
| id | doaj.art-30520ee13c714e99a564c2f59ad5f6a2 |
| institution | Directory Open Access Journal |
| issn | 2234-943X |
| language | English |
| last_indexed | 2024-04-24T07:42:11Z |
| publishDate | 2024-04-01 |
| publisher | Frontiers Media S.A. |
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| series | Frontiers in Oncology |
| spelling | doaj.art-30520ee13c714e99a564c2f59ad5f6a22024-04-19T11:41:31ZengFrontiers Media S.A.Frontiers in Oncology2234-943X2024-04-011410.3389/fonc.2024.13756481375648Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomyHaoyu Zhao0Baifeng Li1Xiaohang Li2Xiangning Lv3Tingwei Guo4Zongbo Dai5Chengshuo Zhang6Jialin Zhang7Department of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Radiology, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaDepartment of Hepatobiliary Surgery, The First Hospital of China Medical University, Shenyang, ChinaBackgroundFor patients with hilar cholangiocarcinoma (HC) undergoing hemi-hepatectomy, there are controversies regarding the requirement of, indications for, and timing of preoperative biliary drainage (PBD). Dynamic three-dimensional volume reconstruction could effectively evaluate the regeneration of liver after surgery, which may provide assistance for exploring indications for PBD and optimal preoperative bilirubin value. The purpose of this study was to explore the indications for PBD and the optimal preoperative bilirubin value to improve prognosis for HC patients undergoing hemi-hepatectomy.MethodsWe retrospectively analyzed the data of HC patients who underwent hemi-hepatectomy in the First Affiliated Hospital of China Medical University from 2012 to 2023. The liver regeneration rate was calculated using three-dimensional volume reconstruction. We analyzed the factors affecting the liver regeneration rate and occurrence of postoperative liver insufficiency.ResultsThis study involved 83 patients with HC, which were divided into PBD group (n=36) and non-PBD group (n=47). The preoperative bilirubin level may be an independent risk factor affecting the liver regeneration rate (P=0.014) and postoperative liver insufficiency (P=0.016, odds ratio=1.016, β=0.016, 95% CI=1.003–1.029). For patients whose initial bilirubin level was >200 μmol/L (n=45), PBD resulted in better liver regeneration in the early stage (P=0.006) and reduced the incidence of postoperative liver insufficiency [P=0.012, odds ratio=0.144, 95% confidence interval (CI)=0.031–0.657]. The cut-off value of bilirubin was 103.15 μmol/L based on the liver regeneration rate. Patients with a preoperative bilirubin level of ≤103.15 μmol/L shown a better liver regeneration (P<0.01) and lower incidence of postoperative hepatic insufficiency (P=0.011, odds ratio=0.067, 95% CI=0.008–0.537).ConclusionFor HC patients undergoing hemi-hepatectomy whose initial bilirubin level is >200 μmol/L, PBD may result in better liver regeneration and reduce the incidence of postoperative liver insufficiency. Preoperative bilirubin levels ≤103.15 μmol/L maybe recommended for leading to a better liver regeneration and lower incidence of postoperative hepatic insufficiency.https://www.frontiersin.org/articles/10.3389/fonc.2024.1375648/fullhilar cholangiocarcinomaliver regenerationbilirubinpreoperative biliary drainageliver insufficiency |
| spellingShingle | Haoyu Zhao Baifeng Li Xiaohang Li Xiangning Lv Tingwei Guo Zongbo Dai Chengshuo Zhang Jialin Zhang Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy Frontiers in Oncology hilar cholangiocarcinoma liver regeneration bilirubin preoperative biliary drainage liver insufficiency |
| title | Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy |
| title_full | Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy |
| title_fullStr | Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy |
| title_full_unstemmed | Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy |
| title_short | Dynamic three-dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi-hepatectomy |
| title_sort | dynamic three dimensional liver volume assessment of liver regeneration in hilar cholangiocarcinoma patients undergoing hemi hepatectomy |
| topic | hilar cholangiocarcinoma liver regeneration bilirubin preoperative biliary drainage liver insufficiency |
| url | https://www.frontiersin.org/articles/10.3389/fonc.2024.1375648/full |
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