Regeneration of Liver: Portal Vein Embolization Versus Radiofrequency Assisted Ligation for Liver Hypertrophy (REBIRTH) (REBIRTH)
Liver Resection, Cancer
About this trial
This is an interventional treatment trial for Liver Resection focused on measuring Liver hypertrophy, Liver resection, Liver metastases, Portal vein ligation, Portal vein embolization, Radiofrequency splitting
Eligibility Criteria
Inclusion Criteria:
- Age ≥ 18 years
- Any patient requiring right or extended right hepatectomy with FLRV less than 25% on preoperative volumetric study
- WHO performance status 0, 1 or 2
- Patient able to comply with protocol requirements and deemed fit for surgical resection
- Written informed consent
Exclusion Criteria:
- Inability to give informed consent
- Pregnancy
- WHO status 3 or 4
- New York Heart Association Classification Grade III or IV
Sites / Locations
- Hammersmith Hospital
Arms of the Study
Arm 1
Arm 2
Active Comparator
Experimental
Portal vein embolization (PVE)
Radiofrequency assisted liver partition and ligation (RALPP)
Patients allocated to the PVE group will receive pre-intervention blood tests and a contrast enhanced CT scan of the abdomen. They will then have their portal vein embolized radiologically once their pre-intervention investigations have been completed and reviewed by the clinical team. Post-intervention investigations (blood tests and CT scan) will take place 4 weeks after the completion of the PVE. At this point, they will be listed to receive their definitive surgical hepatectomy.
Patients allocated to the RALPP group will receive pre-intervention blood tests and a contrast enhanced CT scan of the abdomen. They will then have their right portal vein surgically ligated followed by radiofrequency ablation in situ splitting of the liver. Certain patients may additionally have a tumourectomy or wedge resection of the left liver lobe if clinically indicated. The RALPP procedure will occur once the patient's pre-intervention investigations have been completed and reviewed by the clinical team. Post-intervention investigations (blood tests and CT scan) will take place 2 weeks after the completion of the RALPP. At this point, they will be listed to receive their definitive surgical hepatectomy.