Embolización portal prequirúrgica

This article describes the commonly accepted inclusion and exclusion criteria used for PPE. There is no consensus, however, regarding the most appropriate technique for accessing the portal system. For example, the contralateral approach (with puncture of the portal segments that are not to be resected) has considerable technical advantages, but places the portal branches of healthy liver tissue at risk for thrombosis. Many different materials have been used for embolization in PPE. Some authors recommend the use of “glues”, as these are relatively easy to use, low cost, and highly efficacious; however, they also generate significant periportal inflammation that can make surgical resection more difficult. If particles are used, they should measure between 100-300 micras. In conclusion, although many aspects of PPE still need to be investigated, this technique should be made available in all centers performing hepatic surgery, as it can result in significant clinical benefits.