Pre-hepatectomy portal vein embolization: single center experience

European Journal of Surgical Oncology : the Journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology
A R CotroneoR Iezzi

Abstract

To evaluate the feasibility and the effectiveness of portal vein embolization (PVE) as preoperative treatment in patients scheduled to undergo right hepatectomy, when the volume of the future remnant liver (FRL) appears to be insufficient to prevent the risk of post-surgical hepatic failure. Thirty-one consecutive patients (19 men, 12 women; age range: 54-77 years; mean age: 66.2 years) with liver malignancy (7 hepatocellular carcinoma, 13 metastases, 9 cholangiocarcinoma, and 2 gallbladder carcinoma) were selected after clinical-radiological evaluation for PVE. After the embolization changes in volume of FRL, portal pressure, liver enzymes, and complications before and after hepatectomy were assessed. PVE was successful in all patients without major complications. The mean volume of FRL, calculated before and 4 weeks after PVE, increased from 319.2 +/- 45.1 to 460.2 +/- 27.7 cm(3) (+44.2%) in the non-cirrhotic group and from 458.4 +/- 38.3 to 605.2 +/- 27 cm(3) (+32.1%) in the cirrhotic group. The FRL/TELV ratio increased by 9%. In our experience, PVE resulted feasible, safe, with a very low rate of complications, and effective to induce liver regeneration before right hepatectomy in patients with liver malignancy.

References

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Citations

Mar 29, 2014·Indian Journal of Surgical Oncology·Soumil VyasHemant M Kocher
Jul 19, 2012·Cardiovascular and Interventional Radiology·K P van LiendenO M van Delden
Aug 19, 2014·Current Oncology Reports·Mathias WorniBryan M Clary
Aug 28, 2014·Journal of the American College of Surgeons·Universe LeungWilliam R Jarnagin
Feb 13, 2014·Journal of Hepato-biliary-pancreatic Sciences·Ryota Higuchi, Masakazu Yamamoto

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