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Portal vein embolisation for extended hepatectomy: single-centre experience
Soumil Vyas1, Clare Bent, Stefano Partelli
1Division of Hepato-biliary and Pancreatic Surgery, Barts and the London HPB Centre, The Royal London Hospital, London, E1 1BB, UK. soumil_v@yahoo.com
Journal of Gastrointestinal Cancer
|September 28, 2011
Summary
Portal vein embolisation (PVE) safely induces liver hypertrophy, enabling extended hepatectomy. This procedure offers the best chance of cure, particularly for patients with liver metastases.
Area of Science:
- Hepatobiliary surgery
- Interventional radiology
- Surgical oncology
Background:
- Portal vein embolisation (PVE) is a technique used to stimulate hypertrophy of the contralateral liver lobe.
- This hypertrophy is crucial for enabling extended hepatectomy in patients with extensive liver disease.
Purpose of the Study:
- To analyze outcomes of PVE followed by extended hepatectomy.
- To assess the success of PVE, feasibility of resection, operative morbidity, and patient survival.
Main Methods:
- Retrospective analysis of prospectively collected data from 33 patients (2004-2008).
- Survival curves were estimated using the Kaplan-Meier (Breslow) method.
- Statistical significance was set at p < 0.05.
Main Results:
- 31 patients had successful PVE, with significant median liver hypertrophy (230.15 to 428.50 ml).
- 24 patients underwent surgery, including 16 hepatectomies (14 R0, 2 R1), with a single mortality (6.25%) and 56.25% morbidity.
- Median overall survival was 14 months; disease-specific survival was higher for patients undergoing resection (33 months) vs. no resection (8.6 months).
Conclusions:
- PVE is a safe and effective method to facilitate extended hepatectomy.
- The procedure improves the chances of achieving an R0 resection.
- PVE offers the best opportunity for cure, especially in cases of liver metastases.
