Portal vein embolization with plug/coils improves hepatectomy outcome

Area of Science:

• Hepatobiliary Surgery
• Interventional Radiology
• Surgical Oncology

Background:

• Portal vein embolization (PVE) is standard before extensive liver resection.
• Various embolization materials exist for PVE.
• This study compares polyvinyl alcohol particles alone (PVA only) versus PVA with plugs/coils (PVA + plug/coils).

Purpose of the Study:

• To compare the efficacy of two PVE techniques in increasing future liver remnant (FLR) volume.
• To assess the impact of PVE techniques on recanalization rates and postoperative liver failure.
• To evaluate the safety of combined PVA and plug/coil embolization.

Main Methods:

• Retrospective analysis of patients undergoing PVE before hepatectomy.
• Group 1: PVA particles only. Group 2: PVA particles with additional plug/coils.
• Measurement of left lateral liver lobe (LLL) volume, clinical parameters, and liver function tests pre- and post-PVE.

Main Results:

• PVA + plug/coils group showed significantly greater LLL volume increase (44%) compared to PVA only (25.7%).
• Recanalization rates were significantly lower in the PVA + plug/coils group.
• Postoperative liver failure incidence was significantly reduced in the PVA + plug/coils group.

Conclusions:

• PVE with PVA particles and additional plug/coils is safe and effective for increasing FLR volume.
• Combined embolization enhances hypertrophy by reducing recanalization, leading to decreased postoperative liver failure.
• No additional procedure-specific complications were noted with the combined technique.