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[Percutaneous portal vein embolization before major hepatic resection]
Attila Doros1, Viola Weszelits, Mária Puhl
1Semmelweis Egyetem AOK, Transzplantációs és Sebészeti Klinika, 1082 Budapest, Baross u. 23. dorattila@yahoo.com
Magyar Sebeszet
|May 27, 2003
Summary
Preoperative portal vein embolization (PVE) safely increases future liver remnant volume. This enables major liver resections in patients with insufficient liver mass, improving surgical outcomes.
Area of Science:
- Hepatobiliary Surgery
- Interventional Radiology
- Medical Imaging
Background:
- Major liver resections require adequate future liver remnant (FLR) volume.
- Insufficient FLR volume precludes curative surgery for liver tumors.
- Preoperative portal vein embolization (PVE) is a strategy to augment FLR volume.
Observation:
- CT volumetry is used to assess liver volumes.
- PVE involves percutaneous catheterization and embolization of portal vein branches.
- The procedure is performed using a mixture of contrast, antibiotics, and Gelfoam particles.
Findings:
- PVE successfully increased FLR volume in 2 out of 3 patients.
- CT volumetry confirmed significant hypertrophy of the non-embolized liver lobe.
- One patient proceeded to successful right hemihepatectomy after PVE.
Implications:
- PVE is a safe and tolerable procedure for increasing liver volume.
- Enhanced FLR volume facilitates the performance of major liver resections.
- PVE expands surgical options for patients with limited liver reserve.