Portal vein embolization prior to major liver resection

Samuel C L Kuo, Arash Azimi-Tabrizi, Gregory Briggs, Richard Maher, Timothy Harrington, Jaswinder S. Samra, Martin Drummond, Thomas J. Hugh*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

4 Citations (Scopus)

Abstract

Background: Portal vein embolization (PVE) induces compensatory hypertrophy of the future liver remnant volume (FLRV) to improve the safety of major liver surgery by reducing the risk of post-operative liver failure. The aim was to describe our experience of PVE for patients with large or multifocal malignant liver tumours who initially were deemed unresectable. Methods: Perioperative data were retrieved from a prospective database and computed tomographic scans were retrospectively reviewed to calculate volume changes and the degree of liver hypertrophy following PVE. Results: PVE was successful in 23 out of 25 patients and resulted in a change in the mean estimated FLRV from 585 to 788mL following PVE. This represented a 35% increase in the remnant liver parenchymal volume post-embolization (P < 0.01). The procedure was well tolerated and did not compromise the surgical resection in any patient. Nineteen patients went on to have a liver resection following PVE with an in-hospital mortality of 16% (3 out of 19) and a 42% morbidity rate. After a mean follow-up of 31 months (1-130 months), 32% (6 out of 19) of patients are alive and 4 of these (21%) are completely disease-free. Conclusions: PVE results in an increase in the FLRV prior to major hepatectomy. Failure to develop hypertrophy following PVE is a surrogate marker for underlying liver dysfunction. PVE is safe and may increase the pool of patients suitable for liver resection. Long-term survival is similar to those not requiring embolization prior to liver resection.

Original languageEnglish
Pages (from-to)341-345
Number of pages5
JournalANZ Journal of Surgery
Volume84
Issue number5
DOIs
Publication statusPublished - May 2014
Externally publishedYes

Keywords

  • Future liver remnant volume
  • Hepatectomy
  • Liver hypertrophy
  • Liver tumour
  • Portal vein embolization

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