Sex dimorphism in the outcome of preoperative right portal vein embolization

Arch Surg. 2008 Mar;143(3):254-9; discussion 259. doi: 10.1001/archsurg.2007.58.

Abstract

Hypothesis: Although studies indicate that patient sex modulates the process of hepatic regeneration, it remains unknown whether sex has a role in the outcome of preoperative right portal vein embolization (PVE). We analyzed the effects of patient sex on the outcome of right PVE followed by major hepatectomy.

Design: Retrospective study.

Setting: Academic research.

Patients: Eighty-eight patients (42 men and 46 women) who underwent preoperative right PVE for bile duct carcinoma were analyzed retrospectively.

Main outcome measures: The percentage liver volume change, the plasma indocyanine green clearance rate, and the rate of postoperative hepatic failure were compared between men and women.

Results: The mean (SD) volume of the nonembolized lobe after PVE in women (323 [61] mL/m(2)) was statistically significantly greater than that in men (287 [61] mL/m(2)) (P =.008). The mean (SD) ratio of the nonembolized lobe to the total liver volume was also statistically significantly greater in women (45.8% [5.8%]) than in men (42.0% [5.9%]) (P =.003). The mean (SD) indocyanine green clearance rate of the future liver remnant was 0.075 [0.014] in women and 0.056 [0.011] in men (P =.001). The incidence of postoperative hepatic failure was higher in men (12 of 42 [28.6%]) than in women (8 of 46 [17.4%]) (P =.16).

Conclusion: These results indicate that sex dimorphism can be present in the outcome of preoperative right PVE.

Publication types

  • Comparative Study

MeSH terms

  • Aged
  • Biliary Tract Neoplasms / surgery
  • Biliary Tract Neoplasms / therapy*
  • Coloring Agents / pharmacokinetics
  • Embolization, Therapeutic*
  • Female
  • Hepatectomy* / adverse effects
  • Humans
  • Indocyanine Green / pharmacokinetics
  • Liver Failure / etiology
  • Liver Regeneration
  • Male
  • Middle Aged
  • Neoadjuvant Therapy
  • Portal Vein*
  • Preoperative Care
  • Retrospective Studies
  • Sex Factors
  • Treatment Outcome

Substances

  • Coloring Agents
  • Indocyanine Green