Portal vein embolization in hilar cholangiocarcinoma.
In patients with hilar cholangiocarcinoma, extended hepatectomy and caudate lobe resection are often performed to achieve an R0 resection. In patients whose standardized future liver remnant is less than or equal to 20% of total liver volume, portal vein embolization (PVE) should be performed. In patients with biliary dilatation of the future liver remnant, a biliary drainage catheter should be placed before PVE. If the planned surgery is an extended right hepatectomy, segment 4 branch embolization improves the hypertrophy of segments 2 and 3. In high-volume centers, PVE can be safely performed; it increases the resectability rate and results in the same survival rates as those in patients who undergo resection without PVE.
Palavecino
Martin
M
Department of Surgical Oncology, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Boulevard, Unit 444, Houston, TX 77030, USA.
Abdalla
Eddie K
EK
Madoff
David C
DC
Vauthey
Jean-Nicolas
JN
D001650:Bile Duct Neoplasms / Q000473:pathology / Q000628:therapy*; D004621:Embolization, Therapeutic; D006498:Hepatectomy; D006500:Hepatic Duct, Common / Q000473:pathology*; D006801:Humans; D018285:Klatskin Tumor / Q000473:pathology / Q000628:therapy*; D011169:Portal Vein