Preoperative portal vein embolization in hepatobiliary tract malignancy: an experience at King Chulalongkorn Memorial Hospital.
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.
Sirichindakul
Boonchoo
B
Department of Surgery, King Chulalongkorn Memorial Hospital, Bangkok 10330, Thailand. boonchoog1@gmail.com
Nonthasoot
Bunthoon
B
Thienpaitoon
Peera
P
Nivatvongs
Supanit
S
Janchai
Akkawat
A
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