Pre-hepatectomy portal vein embolization: Single center experience

AimTo evaluate the feasibility and the effectiveness of portal vein embolization (PVE) as preoperative treatment in patients scheduled to undergo right hepatectomy, when the volume of the future remnant liver (FRL) appears to be insufficient to prevent the risk of post-surgical hepatic failure.Materials and MethodsThirty-one consecutive patients (19 men, 12 women; age range: 54–77 years; mean age: 66.2 years) with liver malignancy (7 hepatocellular carcinoma, 13 metastases, 9 cholangiocarcinoma, and 2 gallbladder carcinoma) were selected after clinical–radiological evaluation for PVE. After the embolization changes in volume of FRL, portal pressure, liver enzymes, and complications before and after hepatectomy were assessed.ResultsPVE was successful in all patients without major complications. The mean volume of FRL, calculated before and 4 weeks after PVE, increased from 319.2 ± 45.1 to 460.2 ± 27.7 cm3 (+44.2%) in the non-cirrhotic group and from 458.4 ± 38.3 to 605.2 ± 27 cm3 (+32.1%) in the cirrhotic group. The FRL/TELV ratio increased by 9%.ConclusionIn our experience, PVE resulted feasible, safe, with a very low rate of complications, and effective to induce liver regeneration before right hepatectomy in patients with liver malignancy.