Preoperative Portal Vein Embolization in Hepatobiliary Tract Malignancy: An Experience at King Chulalongkorn Memorial Hospital
Boonchoo Sirichindakul, MD*, Bunthoon Nonthasoot, MD*, Peera Thienpaitoon, MD*, Supanit Nivatvongs, MD*, Akkawat Janchai, MD**
Affiliation : * Department of Surgery, King Chulalongkorn Memorial Hospital ** Department of Radiology, King Chulalongkorn Memorial Hospital
Background : Major hepatic resections are increasingly performed for both primary and secondary liver
cancers nowadays. However, morbidity from these operations is still high. One of the dreadful complications,
sometimes lead to fatality, is postoperative liver failure. There are many factors which are associated with
this complication such as chronic liver disease, low residual liver volume after resection. Portal vein
embolization (PVE) is the procedure which increases the liver volume of the non-embolized lobe. Now, PVE
has gained acceptance in many centers to overcome or reduce this complication. This report described
the authors’ experiences of PVE since 2001 at King Chulalongkorn Memorial Hospital.
Materials and Methods : The records of 10 patients who had PVE were reviewed. CT volumetry of the liver was
done before and after procedure. The authors calculated future liver remnant from CT volumetry and
compared this volume to standard liver volume. The postoperative complications and hospital courses of
these patients were also recorded.
Results : Mean growth of future liver remnant (FLR) ratio after PVE was 13.7 + 6.2% (median 13, range
4-25). There was no major complication after PVE. Six patients underwent liver resection and there was no
major complication or mortality. No one had persistent hyperbilirubinemia 2 weeks after operation.
Conclusion : The PVE is the useful and safe optional procedure to increase future liver remnant volume. It not
only reduces the postoperative liver failure but increases the chance for curative resection.
Keywords : Portal vein embolization, Hepatectomy
