title: Preoperative portal vein embolization in hepatobiliary tract malignancy: an experience at King Chulalongkorn Memorial Hospital.
abstract: BACKGROUND
  Major hepatic resections are increasingly performed for both primary and secondary liver cancers nowadays. However, morbidity from these operations is still high. One of the dreadful complications, sometimes lead to fatality, is postoperative liver failure. There are many factors which are associated with this complication such as chronic liver disease, low residual liver volume after resection. Portal vein embolization (PVE) is the procedure which increases the liver volume of the non-embolized lobe. Now, PVE has gained acceptance in many centers to overcome or reduce this complication. This report described the authors' experiences of PVE since 2001 at King Chulalongkorn Memorial Hospital.
  
  
  METHODS
  The records of 10 patients who had PVE were reviewed CT volumetry of the liver was done before and after procedure. The authors calculated future liver remnant from CT volumetry and compared this volume to standard liver volume. The postoperative complications and hospital courses of these patients were also recorded.
  
  
  RESULTS
  Mean growth of future liver remnant (FLR) ratio after PVE was 13.7 +/- 6.2% (median 13, range 4-25). There was no major complication after PVE. Six patients underwent liver resection and there was no major complication or mortality. No one had persistent hyperbilirubinemia 2 weeks after operation.
  
  
  CONCLUSIONS
  The PVE is the useful and safe optional procedure to increase future liver remnant volume. It not only reduces the postoperative liver failure but increases the chance for curative resection.
authors.affiliation: Department of Surgery, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand. boonchoog1@gmail.com
authors.forename: Boonchoo
authors.initials: B
authors.lastname: Sirichindakul
authors.forename: Bunthoon
authors.initials: B
authors.lastname: Nonthasoot
authors.forename: Peera
authors.initials: P
authors.lastname: Thienpaitoon
authors.forename: Supanit
authors.initials: S
authors.lastname: Nivatvongs
authors.forename: Akkawat
authors.initials: A
authors.lastname: Janchai
mesh_terms: D000328:Adult; D000368:Aged; D001661:Biliary Tract Neoplasms / Q000601:surgery / Q000628:therapy*; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006764:Hospitals, Community; D006801:Humans; D008113:Liver Neoplasms / Q000601:surgery / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein / Q000503:physiopathology*; D011300:Preoperative Care; D011446:Prospective Studies; D013785:Thailand; D016896:Treatment Outcome