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Preoperative portal vein embolization: is it useful?
Tadatoshi Takayama1, Masatoshi Makuuchi
1Third Department of Surgery, Nihon University School of Medicine, 30-1 Oyaguchikami-machi, Itabashi-ku, 173-8610, Tokyo, Japan.
Journal of Hepato-Biliary-Pancreatic Surgery
|March 5, 2005
Summary
Portal vein embolization (PVE) is a beneficial procedure that induces liver lobe hypertrophy, improving outcomes for patients undergoing extensive hepatectomy. This technique is particularly useful for those with mild liver dysfunction or complex tumor burdens.
Area of Science:
- Hepatobiliary surgery
- Surgical oncology
- Interventional radiology
Background:
- Portal vein embolization (PVE) is a pre-operative procedure designed to shrink the lobe targeted for resection.
- It aims to stimulate compensatory growth in the remaining liver lobe, enhancing future liver remnant (FLR) function.
Purpose of the Study:
- To evaluate the clinical utility and outcomes of PVE prior to major hepatectomy.
- To determine if PVE is a useful strategy for managing various hepatobiliary tumors.
Main Methods:
- Retrospective review of clinical outcomes in 161 patients who underwent major hepatectomy after PVE.
- Analysis of liver volume changes, hepatic functional data, operative outcomes, and long-term survival rates.
Main Results:
- PVE was well-tolerated with hepatic function returning to baseline within a week.
- A median 8% increase in the contralateral liver lobe volume was observed post-PVE.
- Overall operative morbidity was 19% and mortality was 1.2%, with no mortality in hepatopancreatoduodenectomy cases.
Conclusions:
- PVE is a valuable tool for enabling extensive hepatectomy.
- It is particularly beneficial for patients with mild hepatic dysfunction, bilobar tumors, or those requiring hepatopancreatoduodenectomy.