Portal vein embolization in extended liver resection

Area of Science:

• Hepatobiliary surgery
• Surgical oncology
• Gastroenterology

Background:

• Liver resection for tumors poses risks of postoperative liver insufficiency.
• Future liver remnant (FLR) volume and function are critical determinants of patient outcomes.
• Accurate measurement of liver volume and function, alongside augmentation techniques, is essential for surgeons.

Purpose of the Study:

• To provide a comprehensive review of portal vein embolization (PVE).
• To discuss FLR measurement, patient selection criteria for PVE, and hypertrophy assessment.
• To cover PVE techniques and potential complications.

Main Methods:

• Review of existing literature on portal vein embolization.
• Analysis of FLR measurement techniques and hypertrophy assessment.
• Discussion of PVE techniques, patient factors, and complication profiles.

Main Results:

• Future liver remnant (FLR) volume requirements vary based on patient, disease, and anatomic factors.
• Portal vein embolization (PVE) effectively induces rapid FLR hypertrophy.
• Kinetic growth rate (KGR) is the most reliable metric for predicting postoperative liver function.

Conclusions:

• PVE is a safe and effective procedure at high-volume centers, increasing eligibility for curative hepatectomy.
• PVE significantly reduces the risk of liver failure, enabling more patients to undergo surgery.
• Accurate FLR assessment and PVE are crucial for optimizing outcomes in liver surgery.