Efficacy and safety of percutaneous transhepatic portal embolization before right liver resection using an ethibloc/lipiodol mixture: a single-center experience.
OBJECTIVE
The purpose of this study was to evaluate the safety and efficacy of percutaneous transhepatic portal vein embolization of the right portal vein with an Ethibloc/Lipiodol mixture to induce hypertrophy of the left liver lobe in patients with primarily unresectable liver tumor.


METHODS
15 patients (8 primary liver tumors, 7 liver metastases) underwent portal vein embolization. Liver volumetry, duration of hospitalization, complication rates, relevant laboratory values were documented.


RESULTS
In 13/15 patients (84.6%) embolization could be performed with a median of 8.8 ml (range 1.5-28 ml) Ethibloc/Lipiodol. One minor procedure-related complication (subcapsular hematoma) occurred, which did not affect the two-step liver resection. No patient developed acute liver failure after embolization or liver resection. The volume of the left liver lobe increased significantly (p = 0.0015) by 25% from a median of 750 ml (587-1,114 ml) to 967 ml (597-1,249 ml). 11/13 (81.8%) of the embolized patients underwent liver resection at a median of 49 days after embolization. Median hospitalization time was 4 days after embolization and 7 days after liver resection. Median overall survival of the 11 operated patients was 376 days.


CONCLUSIONS
Percutaneous transhepatic portal vein embolization using an Ethibloc/Lipiodol mixture is a safe, feasible, and efficient interventional procedure.
Radeleff
B
B
Department of Diagnostic Radiology, University of Heidelberg, INF 110 Surgery, Heidelberg, Germany. Boris_radeleff@med.uni-heidelberg.de
Schawo
S
S
Hoffmann
K
K
Schemmer
P
P
Noeldge
G
G
Kauffmann
G W
GW
Froehlich
B
B
Richter
G M
GM
D000328:Adult; D000368:Aged; D003973:Diatrizoate / Q000008:administration & dosage*; D004338:Drug Combinations; D004621:Embolization, Therapeutic; D005227:Fatty Acids / Q000008:administration & dosage*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D007459:Iodized Oil / Q000008:administration & dosage*; D008115:Liver Regeneration; D008297:Male; D008875:Middle Aged; D011169:Portal Vein; D011409:Propylene Glycols / Q000008:administration & dosage*; D011446:Prospective Studies; D012597:Sclerosing Solutions / Q000008:administration & dosage*; D016896:Treatment Outcome; D015028:Zein / Q000008:administration & dosage*
D004338:Drug Combinations; D005227:Fatty Acids; D011409:Propylene Glycols; D012597:Sclerosing Solutions; D003973:Diatrizoate; D007459:Iodized Oil; D015028:Zein; C020481:alcoholic prolamine solution