Clinical significance of portal vein embolization before right hepatectomy.
OBJECTIVE
To identify clinical significances of portal vein embolization (PVE) prior to major hepatectomy, we examined clinical parameters and outcome after right hepatectomy in patients who underwent PVE.


METHODS
The subjects were 30 patients who underwent PVE (PVE group), and 52 patients (non-PVE), in whom PVE was considered unnecessary, followed by right hepatectomy for hepatobiliary cancer.


RESULTS
Total hepatic volume after PVE (1068+/-268 ml) tended to increase compared with before PVE (p=0.059). After PVE, the change in hemi-liver volume was 8.9+/-6.0%. Increases in hepatic volume of non-embolized left liver before and at 4 weeks after hepatectomy between the PVE and non-PVE groups were similar. Changes in hepatic volumes before and after PVE were not significantly influenced by background liver disease. After PVE, the functional liver volume (419+/-185 cm3) was significantly lower than morphological volume (564+/-165 cm3) in the embolized liver (p<0.05). Although preoperative liver function was worse in the PVE group compared with non-PVE, serious hepatic complications were rarely observed in the PVE group.


CONCLUSIONS
Marked changes in hepatic volume were noted after PVE in patients with impaired liver function and those who need large-volume right hepatectomy, especially in functional volume, suggesting that PVE is a useful procedure to prevent postoperative liver failure.
Nanashima
Atsushi
A
Division of Surgical Oncology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan. a-nanasm@net.nagasaki-u.ac.jp
Sumida
Yorihisa
Y
Abo
Takafumi
T
Nonaka
Takashi
T
Takeshita
Hiroaki
H
Hidaka
Shigekazu
S
Sawai
Terumitsu
T
Yasutake
Toru
T
Sakamoto
Ichiro
I
Nagayasu
Takeshi
T
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004621:Embolization, Therapeutic; D005260:Female; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008107:Liver Diseases / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009929:Organ Size; D011169:Portal Vein; D012189:Retrospective Studies; D016896:Treatment Outcome