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Yukihiro Yokoyama, MD; Masato Nagino, MD; Koji Oda, MD; Hideki Nishio, MD; Tomoki Ebata, MD; Tetsuya Abe, MD; Tsuyoshi Igami, MD; Yuji Nimura, MD

Arch Surg. 2008;143(3):254-259.

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/m²) was statistically significantly greater than that in men (287 [61] mL/m²) (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.

Author Affiliations: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.

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Sex Dimorphism in the Outcome of Preoperative Right Portal Vein Embolization—Invited Critique
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Arch Surg. 2008;143(3):259.
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