Portal vein embolization with different embolic agents for right hepatectomy

Area of Science:

• Hepatobiliary Surgery
• Interventional Radiology
• Surgical Oncology

Background:

• Portal vein embolization (PVE) is a technique to induce liver hypertrophy.
• It aims to increase the future liver remnant (FLR) volume before major liver resection.
• Evaluating PVE outcomes and embolic agent efficacy is crucial for surgical planning.

Purpose of the Study:

• To retrospectively assess the efficacy of PVE in inducing FLR hypertrophy.
• To compare outcomes based on different embolic agents used for PVE.
• To evaluate the safety and impact of PVE on subsequent hepatectomy decisions.

Main Methods:

• Retrospective review of 20 PVE procedures performed between 2004-2009.
• Percutaneous right portal vein access with various embolic agents.
• Pre- and post-embolization CT volumetry to measure liver and FLR volumes.

Main Results:

• No major complications were reported following PVE.
• A statistically significant increase in FLR/total liver volume ratio (12.7%) was observed.
• No significant difference in hypertrophy was found between alcohol and other embolic agents.

Conclusions:

• PVE effectively increases FLR volume, with results exceeding some prior studies.
• PVE is a valuable tool for 'gray-zone' patients considered for liver resection.
• Further randomized controlled trials are necessary to identify optimal hypertrophy-inducing agents.