Portal Vein Embolization: History and Current Indications

Shinkawa, Hiroji; Takemura, Shigekazu; Tanaka, Shogo; Kubo, Shoji

doi:10.1159/000479474

Cited by 12 publications

(12 citation statements)

References 21 publications

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“…Since the first report in 1986, PVE has progressively become the gold standard for inducing liver hypertrophy with satisfying safety and efficacy[ 31 ]. Initially described by laparotomy, the portal system access is now obtained by percutaneous puncture of the portal vein.…”

Section: Portal Vein Embolizationmentioning

confidence: 99%

Current strategies to induce liver remnant hypertrophy before major liver resection

Basso¹,

Gaillard²,

Laïnas³

et al. 2021

WJH

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Hepatic resection is the gold standard for patients affected by primary or metastatic liver tumors but is hampered by the risk of post-hepatectomy liver failure. Despite recent improvements, liver surgery still requires excellent clinical judgement in selecting patients for surgery and, above all, efficient pre-operative strategies to provide adequate future liver remnant. The aim of this article is to review the literature on the rational, the preliminary assessment, the advantages as well as the limits of each existing technique for preparing the liver for major hepatectomy.

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Section: Portal Vein Embolizationmentioning

confidence: 99%

Current strategies to induce liver remnant hypertrophy before major liver resection

Basso¹,

Gaillard²,

Laïnas³

et al. 2021

WJH

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“…Optimization techniques of FLR function such as portal vein embolization (PVE) [25], portal vein ligation (PVL) in two-stage hepatectomy [26], and associating liver partition and PVL for staged hepatectomy (ALPPS) [27] created a new situation with regional heterogeneity of liver function, where conventional CT volumetry cannot exert the ability to appropriately divide the liver function measured as a whole, such as K ICG and LiMAx, into the FLR part and the resection part. Nuclear imaging technology is expected to offer a solution to this issue.…”

Section: Evaluation Of Regional Heterogeneity Of Liver Functionmentioning

confidence: 99%

Evaluation of Liver Function and the Role of Biliary Drainage before Major Hepatic Resections

Yamamoto

2020

Visc Med

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Background: Prevention of posthepatectomy liver failure is a prerequisite for improving the postoperative outcome of perihilar cholangiocarcinoma. From this perspective, appropriate assessment of future liver remnant (FLR) function and the optimized preparation are mandatory. Summary: FLR volume ratio using CT volumetry based on 3-dimensional vascular imaging is the current assessment yardstick and is sufficient for assessing a normal liver. However, in a liver with underling parenchymal disease such as fibrosis or prolonged jaundice, weighing up the degree of liver damage against the FLR volume ratio is necessary to know the real FLR function. For this purpose, the indocyanine green (ICG) clearance test, monoethylglycinexylidide (MEGX) test, liver maximum capacity (LiMAX) test, 99mTc-labeled galactosyl human serum albumin (99mTc-GSA) scintigraphy, albumin-bilirubin (ALBI) grade, and ALPlat (albumin × platelets) criterion are used. After the optimization of FLR function by means of portal vein embolization or associating liver partition and PVL (portal vein ligation) for staged hepatectomy (ALPPS), SPECT scintigraphy with either 99mTc-GSA or 99mTc-mebrofenin compensates for misestimation due to the regional heterogeneity of liver function. The role of preoperative biliary drainage has long been debated, with the associated complications having led to a lack of approval. However, the recent establishment of safety and an improvement in success rates of endoscopic biliary drainage seem to be changing the awareness of the importance of biliary drainage. Key Messages: Appropriate selection of an assessment method is of prime importance to predict the FLR function according to the preoperative condition of the liver. Preoperative biliary drainage in patients with perihilar cholangiocarcinoma is gaining support due to the increasing safety and success rate, especially in patients who need optimization of their liver function before hepatectomy.

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“…There have been numerous review articles about PVE; however, articles specific for HCC remain limited and all of them mainly discussed the PVE procedure and liver regeneration effect. [35][36][37] In this review, we will summarize the role of PVE for HCC with special attention to oncological effects.…”

Section: Ta B L E 1 Long-term Outcome After Hepatectomy For Hepatocellular Carcinoma Patients With or Without Portal Vein Embolizationmentioning

confidence: 99%

Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma

Beppu

Yamamura

Okabe

et al. 2020

Annals of Gastroent Surgery

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Portal vein embolization (PVE) has been carried out for various hepatobiliary malignancies such as hepatocellular carcinoma (HCC). 1-9 PVE for HCC was first introduced in 1986 by the Osaka City University group in Japan. 1 PVE is mainly done to obtain a larger future liver remnant (FLR) to expand the safety zone of liver resection. Even for HCC patients with fibrous livers, liver resectability is increased after PVE without increasing morbidity and mortality. 3,5,7 Previous studies have assessed liver resectability based on liver function and FLR volume using computed tomography (CT)volumetry. [8][9][10][11] Nowadays, functional liver volumetry using 99m Tc-galactosyl human serum albumin scintigraphy single-photon emission CT is used to assess partial liver function after PVE. 12-16 PVE can provide a larger functional volume of the FLR as compared to those before PVE. Additionally, the functional volume ratio after PVE has

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Portal Vein Embolization: History and Current Indications

Cited by 12 publications

References 21 publications

Current strategies to induce liver remnant hypertrophy before major liver resection

Current strategies to induce liver remnant hypertrophy before major liver resection

Evaluation of Liver Function and the Role of Biliary Drainage before Major Hepatic Resections

Oncological benefits of portal vein embolization for patients with hepatocellular carcinoma

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