Liver Venous Deprivation for Rapid Liver Hypertrophy before major Hepatectomy: A Case Report

Nathan John¹, Lisandro Montorfano¹, Arun Nagarajan², Conrad Simpfendorfer¹, Parag Amin³ , Mayank Roy^1*

¹Department of General Surgery, Section of Hepatobiliary and Pancreatic Surgery,Cleveland Clinic Florida, Weston, Florida, USA

²Department of Hematology and Medical Oncology, Cleveland Clinic Florida, Weston,Florida, USA

³Department of Imaging, Section of Interventional Radiology, Cleveland Clinic Florida, Weston, Florida, USA

*Corresponding Author: Mayank Roy 
Department of General Surgery, 2950 Cleveland Clinic Florida, Weston, Florida, 33326, USA
E-mail: roym@ccf.org

Received: July 12, 2022; Manuscript No: COCR-22-69088;
Editor Assigned: July 14, 2022; PreQC Id: COCR-22-69088 (PQ);
Reviewed: July 25, 2022; QC No: COCR-22-69088 (Q);
Revised: July 26, 2022; Manuscript No: COCR-22-69088 (R);
Published: July 31, 2022; DOI: 10.4172/cocr.5(7).241

Citation: John N, et al. (2022) Liver Venous Deprivation for Rapid Liver Hypertrophy before Major Hepatectomy: A Case Report. Clin Oncol Case Rep 5:7

Liver Venous Deprivation (LVD) is an emerging minimally invasive strategy to induce rapid liver hypertrophy of the Future Liver Remnant (FLR) before a major hepatectomy. LVD (aka “double vein embolization”) entails same-session percutaneous embolization of the portal and hepatic veins of the planned liver resection. This report discusses the utilization and technical challenges of LVD in managing of a 49-year-old male with recurrent multifocal Colorectal Liver Metastases (CRLM). The patient initially underwent neoadjuvant FOLFOX chemotherapy followed by a simultaneous laparoscopic sigmoid colectomy and liver surgery (microwave ablation of segment 5^th, and wedge resections of segment 1^st and 4^thb), followed by completion of chemotherapy. The patient had a R0 resection with clear colon and liver surgical margins. Nine months after the initial surgery, the patient had a rise in tumor markers, and surveillance imaging demonstrated recurrence of liver metastases in segments 1^st and 5^th. LVD was performed by interventional radiology, which led to 28% increase in FLR (segments 2^nd, 3^rd, and 4^th); initially measuring 464 cm3 prior to LVD and measuring 594 cm3 by post-procedure day 21. The patient underwent right hemi-hepatectomy and caudate resection on post-procedure day 29. The patient did not have any complication and discharged on postoperative day six. The patient remains disease-free with no evidence of recurrence at twelve months follow up.