Role of portal vein embolization in hepatobiliary malignancy.
OBJECTIVE
Inadequate remnant liver volume is the major cause of postoperative liver failure. Preoperative portal vein embolization (PVE) is the well accepted procedure to increase future liver remnant (FLR) volume and decrease the incidence of this complication. This study described the author's experience of preoperative PVE at King Chulalongkorn Memorial Hospital since 2002.


METHODS
The clinical data of 29 patients who underwent PVE were reviewed. The FLR volumes before and after the procedure were calculated by CT volumetry. PVE was performed when estimated FLR volume was < 25% in normal liver or < 40% in damaged liver and also when major liver resection combined with major intraabdominal surgery was planned. The complications after PVE and hepatectomy were recorded.


RESULTS
There were no deaths or complications after PVE. The mean growth of FLR was 11%. Power of liver regeneration was suboptimal in old age patients. Sixteen patients underwent liver resection (resectability rate 55.17%). There were 2 cases of postoperative hyperbilirubinemia (12.5%). The hospital mortality rate was 1/16 (6.25%).


CONCLUSIONS
PVE is a useful and safe optional procedure to increase FLR. It not only reduces the postoperative liver failure but also increases the chance of curative resection.
Sirichindakul
Boonchoo
B
Department of Surgery, Faculty of Medicine, King Chulalongkorn Memorial Hospital, Bangkok, Thailand. boonchoo5@mailcity.com
Nonthasoot
Bunthoon
B
Taesombat
Wipusit
W
Supaphol
Jade
J
Nivatvongs
Supanit
S
Janchai
Akkawat
A
Tantivatana
Jarturon
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001650:Bile Duct Neoplasms / Q000628:therapy*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000628:therapy*; D003487:Cyanoacrylates / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000379:methods; D004659:Enbucrilate; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D019990:Perioperative Care; D011169:Portal Vein; D012189:Retrospective Studies
D003487:Cyanoacrylates; D004659:Enbucrilate