Portal vein embolization with different embolic agents for right hepatectomy.
OBJECTIVE
We aimed to retrospectively evaluate our experience in portal vein embolization that induces hypertrophy of the future liver remnant before right hepatectomy and to determine the differences in outcome with respect to the embolic agents used.


METHODS
Twenty right portal vein embolization procedures performed in our institution between 2004 and 2009 were reviewed in this study. The average patient age was 59 years (range: 45-72 years). Embolization was performed through a right portal vein percutaneous access with use of the combination of several agents. Computed tomography volumetry was performed before and 4-6 weeks after the procedure to measure total liver volume and future liver remnant.


RESULTS
There was no major complication related to the embolization procedures. After embolization, future liver remnant/total liver volume ratio increased to 12.7%, which was statistically significant. No significant difference was noted in hypertrophic outcomes between alcohol and the other embolic agents. Although five patients had sufficient future liver remnant, they did not undergo subsequent hepatectomy for a variety of reasons.


CONCLUSIONS
According to our results, the mean increase in the size of the future liver remnant was greater than reported in previous studies of portal vein embolization. Despite the limited patient number of our study, we believe that portal vein embolization is helpful especially in gray-zone patients who may be a good candidate for surgical resection and thus possible cure. However, randomized, controlled studies with hypertrophy- inducing agents are needed.
Selcuk University, Meram School of Medicine, Department of Radiology, Konya, Turkey. drosmankoc@yahoo.com
Bora
B
Peynırcıoğlu
Barbaros
B
Cıl
Fuat
F
Ozkan
Osman
O
Koç
Devrim
D
Akinci
Osman
O
Abbasoğlu
Erhan
E
Hamaloğlu
Ferhun
F
Balkanci
D000368:Aged; D003487:Cyanoacrylates / Q000627:therapeutic use; D004621:Embolization, Therapeutic / Q000379:methods*; D000431:Ethanol / Q000627:therapeutic use; D005260:Female; D006490:Hemostatics / Q000627:therapeutic use*; D006498:Hepatectomy / Q000379:methods*; D006801:Humans; D008099:Liver / Q000000981:diagnostic imaging / Q000473:pathology*; D008113:Liver Neoplasms / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D011142:Polyvinyl Alcohol / Q000627:therapeutic use; D011169:Portal Vein; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed
D003487:Cyanoacrylates; D006490:Hemostatics; D000431:Ethanol; D011142:Polyvinyl Alcohol