Preoperative portal vein embolization with a mixture of gelatin sponge and iodized oil: efficacy and safety.
OBJECTIVE
To evaluate whether portal vein embolization (PVE) using a mixture of gelatin sponge (GS) pieces and iodized oil is safe and effective in inducing hypertrophy of the future liver remnants (FLR).


METHODS
PVE was performed in 14 patients (eight male and six female, mean age 65 years, range 35-81 years) diagnosed with malignant liver tumor before surgery, whose FLR volumes were judged too small to allow for safe resection. Liver volume change, biochemical data change, complications related to PVE, and postoperative complications were retrospectively evaluated.


RESULTS
PVE was successful in all patients, and there were no procedural complications. Absolute FLR volume and FLR/total liver volume (TLV) ratio increased by 102 cm3 and 8% (mean values), respectively. Planned hepatectomies were cancelled in three patients due to extrahepatic metastasis or bile duct infection. Five of the 11 patients (45%) who underwent hepatectomies had major postoperative complications. However, complications due to hepatic failure were not seen. In 10 patients, except one whose outcome was fatal outcome, the mean hospitalization days with and without major complications were 73 and 33 days, respectively.


CONCLUSIONS
PVE using a mixture of GS and iodized oil seems to be effective and safe in inducing hypertrophy of the FLR.
Kakizawa
H
H
Department of Radiology, Hiroshima University Hospital, Hiroshima, Japan. kakizawa@hiroshima-u.ac.jp
Toyota
N
N
Arihiro
K
K
Naito
A
A
Fujimura
Y
Y
Hieda
M
M
Hirai
N
N
Tachikake
T
T
Matsuura
N
N
Murakami
Y
Y
Itamoto
T
T
Ito
K
K
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D004621:Embolization, Therapeutic / Q000379:methods*; D005260:Female; D005780:Gelatin / Q000627:therapeutic use*; D006498:Hepatectomy; D006801:Humans; D007459:Iodized Oil / Q000627:therapeutic use*; D008113:Liver Neoplasms / Q000175:diagnosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011300:Preoperative Care; D016896:Treatment Outcome
D007459:Iodized Oil; D005780:Gelatin