[Percutaneous portal vein embolization before major hepatic resection].
Major liver resection cannot be performed when the remaining liver mass is too small. Preoperative embolization of the portal vein (PVE) helps to increase the volume of the non-tumorous liver segments, and patients' liver function will remain stable postoperatively. CT, MRI, CTAP examinations help to decide about surgery. Volume measurements are performed based on data of CT scans. PVE is indicated, when the remaining, non-tumorous liver volume is too small. The procedure starts with percutaneous portal vein catheterization, then selected portal vein branches are embolized with a mixture of contrast material, antibiotics and Gelfoam particles. The patients stay in the hospital 3-5 days after the procedure. Control CT-volumetry is done after 3-6 weeks. From November 2001 to April 2002 3 patients were selected to have this procedure. PVE of the right portal branches were performed successfully in two cases. Control CT-volumetry showed significant increase of the volume of the left liver lobe. One patient underwent successful right hemihepatectomy. On the third patient we could not catheterize the portal vein. PVE is a relatively safe and tolerable procedure. The increased remaining liver volume helps in performing major liver resection.
Doros
Attila
A
Semmelweis Egyetem AOK, Transzplantációs és Sebészeti Klinika, 1082 Budapest, Baross u. 23. dorattila@yahoo.com
Weszelits
Viola
V
Puhl
Mária
M
Fehérvári
Imre
I
Alföldy
Ferenc
F
D000279:Administration, Cutaneous; D000368:Aged; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016461:Chemoembolization, Therapeutic / Q000379:methods; D015179:Colorectal Neoplasms / Q000473:pathology; D003287:Contrast Media / Q000008:administration & dosage; D005260:Female; D005781:Gelatin Sponge, Absorbable / Q000008:administration & dosage; D006490:Hemostatics / Q000008:administration & dosage; D006498:Hepatectomy / Q000379:methods; D006801:Humans; D008113:Liver Neoplasms / Q000556:secondary / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000000981:diagnostic imaging; D011172:Portography; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome
D000900:Anti-Bacterial Agents; D003287:Contrast Media; D006490:Hemostatics