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Portal vein embolization: rationale, technique and future prospects.
E K Abdalla1, M E Hicks, J N Vauthey
1Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, Houston, Texas 77030, USA.
The British Journal of Surgery
|February 13, 2001
Summary
Portal vein embolization (PVE) can help increase liver remnant size before major liver resection, with low complication rates. This technique is indicated for selected patients to reduce post-surgery complications.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
Background:
- Major liver resection complications persist despite surgical advances.
- Inadequate postresection hepatic size and function are key concerns.
- Portal vein embolization (PVE) aims to increase liver remnant volume via hypertrophy.
Purpose of the Study:
- Review techniques, complications, and outcomes of PVE before liver resection.
- Evaluate the efficacy and safety of PVE in surgical candidates.
- Clarify indications for PVE in liver surgery.
Main Methods:
- Medline search for studies on PVE preceding hepatic resection.
- Review of PVE techniques, associated complications, and patient outcomes.
- Analysis of different embolic agents and their effectiveness.
Main Results:
- PVE complications occur in <5% of patients; no single embolic agent is superior.
- Average remnant liver volume increase is 12% of total liver volume.
- Morbidity and mortality rates after resection are reduced, especially in patients with compromised liver function.
Conclusions:
- PVE is a safe adjunct, not increasing risks of major liver resection.
- PVE is indicated for selected patients needing major liver resection.
- Further prospective studies are needed to refine PVE indications.