Background
The aim of this study was to report the results of preoperative contralateral portal
vein embolization (PVE) performed in a single institution.
Methods
Between January 1997 and March 2006, 146 patients requiring a right or extended right
hepatectomy for primary or secondary liver tumors underwent contralateral PVE when
the future remnant liver volume (FRL) was less than 30% of total liver. Liver volumes
and hepatic function were evaluated before and after PVE.
Results
Contralateral PVE was performed successfully in 145 patients. In one patient, the
catheterization of the left portal branch failed. Complications occurred in 14 patients
(10%) including a transitory fever (n = 9), a parenchymal hematoma (n = 1), a mild
hemoperitoneum (n = 1), a mesenterico-portal venous thrombosis (n = 1), a pulmonary
embolism (n = 1) and a systemic sepsis (n = 1). The prothrombine ratio and the platelet
count were significantly lower 3 days after PVE. Insufficient hypertrophy of the FRL
was observed in 8 patients, malignant disease progression in 15, and both insufficient
hypertrophy and disease progression in 4. The hypertrophy rate of the FRL 4 to 8 weeks
after PVE was 47.7 ± 31.9%. Pathological type of the liver tumor, cirrhosis, diabetes
mellitus, and chemotherapy did not affect the volume of the left liver hypertrophy.
However, the time required to achieve an adequate liver hypertrophy was significantly
shorter in patients with normal liver. One-hundred and fourteen patients (78.6%) subsequently
underwent hepatic resection.
Conclusions
The results suggest that contralateral PVE is a safe and efficient procedure inducing
adequate hypertrophy of the FRL before major liver resection.
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Article info
Publication history
Accepted:
December 24,
2007
Identification
Copyright
© 2008 Mosby, Inc. Published by Elsevier Inc. All rights reserved.
