Aim: To evaluate the feasibility and the effectiveness of portal vein embolization (PVE) as preoperative treatment in patients scheduled to undergo right hepatectomy, when the volume of the future remnant liver (FRL) appears to be insufficient to prevent the risk of post-surgical hepatic failure. Materials and Methods: Thirty-one consecutive patients (19 men, 12 women; age range: 54e77 years; mean age: 66.2 years) with liver malignancy (7 hepatocellular carcinoma, 13 metastases, 9 cholangiocarcinoma, and 2 gallbladder carcinoma) were selected after clinicaleradiological evaluation for PVE. After the embolization changes in volume of FRL, portal pressure, liver enzymes, and complications before and after hepatectomy were assessed. Results: PVE was successful in all patients without major complications. The mean volume of FRL, calculated before and 4 weeks after PVE, increased from 319.2 45.1 to 460.2 27.7 cm3 (þ44.2%) in the non-cirrhotic group and from 458.4 38.3 to 605.2 27 cm3 (þ32.1%) in the cirrhotic group. The FRL/TELV ratio increased by 9%. Conclusion: In our experience, PVE resulted feasible, safe, with
Pre-hepatectomy portal vein embolization: single center experience.
COTRONEO, Antonio Raffaele;INNOCENTI, Paolo;LEGNINI, Margherita;
2009-01-01
Abstract
Aim: To evaluate the feasibility and the effectiveness of portal vein embolization (PVE) as preoperative treatment in patients scheduled to undergo right hepatectomy, when the volume of the future remnant liver (FRL) appears to be insufficient to prevent the risk of post-surgical hepatic failure. Materials and Methods: Thirty-one consecutive patients (19 men, 12 women; age range: 54e77 years; mean age: 66.2 years) with liver malignancy (7 hepatocellular carcinoma, 13 metastases, 9 cholangiocarcinoma, and 2 gallbladder carcinoma) were selected after clinicaleradiological evaluation for PVE. After the embolization changes in volume of FRL, portal pressure, liver enzymes, and complications before and after hepatectomy were assessed. Results: PVE was successful in all patients without major complications. The mean volume of FRL, calculated before and 4 weeks after PVE, increased from 319.2 45.1 to 460.2 27.7 cm3 (þ44.2%) in the non-cirrhotic group and from 458.4 38.3 to 605.2 27 cm3 (þ32.1%) in the cirrhotic group. The FRL/TELV ratio increased by 9%. Conclusion: In our experience, PVE resulted feasible, safe, withI documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
