Arguments for a selective approach of preoperative portal vein embolization before major hepatic resection.
Preoperative PVE can induce hypertrophy of the future liver remnant volume resulting in a decrease of surgical risk after major hepatic resection. However, the number of patients with normal liver at risk is small and there is no arguments for inducing hypertrophy before standard right hepatectomy. Therefore, in patients with normal liver PVE is indicated in patients in whom very extended liver resection or associated major gastro-intestinal surgery is planned. In patients with chronic liver disease and in those with injured liver (chemotherapy, major steatosis, cholestasis), PVE is indicated before major liver resection.
Belghiti
Jacques
J
Department of Hepatopancreatobiliary Surgery and Liver Transplantation, Assistance Publique/Hôpitaux de Paris (University Paris 7), Hospital Beaujon, 92110, Clichy, France.
D000368:Aged; D004621:Embolization, Therapeutic / Q000009:adverse effects; D006498:Hepatectomy; D006801:Humans; D006984:Hypertrophy; D008099:Liver / Q000473:pathology; D011169:Portal Vein; D011300:Preoperative Care; D016896:Treatment Outcome