The technical aspects of a feasible new technique for ipsilateral percutaneous transhepatic portal vein embolization

Abstract

This is the first study to investigate the efficacy of injecting ethanol via a sheath under proximal balloon occlusion of the right portal vein using a single-balloon catheter.

Preoperative Portal Vein Embolization for Liver Resection: An updated meta-analysis

“…Several mature techniques for PVE have been introduced, including transileocolic portal vein embolization (TIPE), the percutaneous transhepatic ipsilateral or contralateral PVE technique (PTPE), and intraoperative portal branch embolization 32 - 34 . It is demonstrated that a greater increase in FRL in PTPE than in surgical TIPE, as well as no difference in the occurrence of major complications 6 .…”

“…Recent researches reported quantitative liver function tests, such as 99 Tc-labelled mebrofenin hepatobiliary scintigraphy HBS and 99 Tc-galactosyl-human serum albumin (GSA) scintigraphy, are conducive to select appropriate patients for PVE [31]. Several mature techniques for PVE have been introduced, including transileocolic portal vein embolization (TIPE), the percutaneous transhepatic ipsilateral or contralateral PVE technique (PTPE), and intraoperative portal branch embolization [32][33][34]. It is demonstrated that a greater increase in FRL in PTPE than in surgical TIPE, as well as no difference in the occurrence of major complications [6].…”

“…Author PVE indications Okabe [46] ICG≤10% and FLR<35% or 10%<ICG<20% and FLR<60% Yamashita [2] FLR≤40% Shindoh [6] FLR≤20% in patients with normal liver or FLR≤30% in patients with liver fibrosis Fischman [37] FLR≤20% in patients with normal liver or FLR≤30% in patients with history of chemotherapy or FLR≤40% in patients with liver fibrosis Luz [41] FLR≤25% in patients with normal liver or FLR≤40% in patients with liver fibrosis Alvarez [23] FLR≤30% in patients with normal liver or FLR≤40% in patients with liver fibrosis Marti [24] FLR≤40% Tsurusaki [32] NR Cotroneo [25] FLR≤25% Giraudo [33] FLR≤30% in patients with normal liver or FLR≤40% in patients with liver fibrosis Ribero [9] FLR≤20% in patients with normal liver or FLR≤30% in patients with history of chemotherapy or FLR≤40% in patients with liver fibrosis Kakizawa [42] NR Beal [48] NR Elias [16] FLR≤30% in patients with normal liver or FLR≤40% in patients with history of chemotherapy Madoff [36] FLR≤25% Jaberi [44] FLR<30% in patients with normal liver or FLR<40% in patients with history of chemotherapy Hemming [26] FLR≤25% in patients with normal liver or FLR≤40% in patients with liver fibrosis Sofue [43] ICG<15% and FLR<40% Geisel [38] FLR≤25% in patients with normal liver or FLR≤40% in patients with liver fibrosis Ratti [27] FLR<30% in patients with normal liver or FLR<40% in patients with history of chemotherapy Radeleff [39] FLR≤25% in patients with normal liver or FLR≤45% in patients with liver fibrosis Cazejust [40] FLR≤25% in patients with normal liver or FLR≤30% in patients with history of chemotherapy or FLR≤40% in patients with liver fibrosis Kuo [17] NR Camelo [45] NR Loveday [28] FLR≤40% Yamashita [29] ICG<10% and FLR≤40% or 10%<ICG≤20% and FLR<50% Abbreviation: PVE: portal vein embolization; ICG: indocyanine green; FLR: future liver remnant; NR: not reported. [23,24,41] Absolute ethanol [23,…”

“…All patients with complications received expectant treatment without affecting subsequent liver resection (Table 4). [16,17,23,25,27] 69 Fever [16,23,25,27,33,36,45] 81 Coil displacement [6,9,23,29,33,37,40,41] 42 Portal vein thrombosis [6,9,23,29,36,41,43,48] 30 Subcapsular hematoma [6,9,29,32,33,36,39] 14 Nausea and vomiting [33,44,45] 12 Hepatic abscess [23,43,44] 7 Subcapsular biloma [38,41] 5 Esophageal bleeding [6,9] 2 Liver failure [23] 4 Hemoperitoneum [33,45] 2 Portal hypertension [40]...…”

Efficacy of Portal Vein Embolization with a Procedure of Sheath Injection and Balloon Occlusion with Gelatin Sponge

“…Tsurusaki's team achieved an adequate increase in FLR/TLV ratio utilizing the same method of PVE-SIBO, but they used absolute ethanol, a pure liquid, as their embolization agent [9]. Although easily injected through the gap between the sheath and catheter, absolute alcohol can induce strong hepatic inflammation after embolization that may cause adhesions that interfere with operational manipulation during hepatectomy [10,11].…”