Importance of hepatic vein occlusion for liver volume induction before extended liver resection

Background: The aim of this study was to investigate the efficacy of hepatic vein occlusion (HVO) compared to portal vein occlusion (PVO) to increase the volume of future liver remnant (FLR) in a porcine model. Material & Methods: Nine animals (4 months old, weight range 52-56kg) were included in this study. We performed a left liver vein occlusion with a vascular stapler on six pigs and a portal vein ligation on three pigs by open surgery. Prior to and on postoperative day 14 liver volumetry was performed by CT scan. Additionally, ICG clearance for liver function and portal pressure were measured. Results: The increase of the right liver volume was 63,2% after PVO and 62,5% after HVO. A deterioration of liver function or an increase in portal venous pressure could not be detected. Conclusion: Liver vein occlusion is a technically feasible approach and leads to liver hypertrophy which is comparable with liver volume after portal vein ligation. The hepatic vein occlusion may also be combined with the PVO for selectively segment combinations.