The transjugular approach is a safe and effective alternative for performing portal vein embolization

Abstract

To evaluate the safety and efficacy of the novel technique, transjugular portal vein embolization (TPVE).A single-center retrospective review of 18 patients (12 males and 6 females; mean age, 62 years) who underwent TPVE between January 2012 and January 2013 was conducted. The technical success rate, future liver remnant (FLR) volume, total liver volume (TLV) and FLR/TLV ratio after PVE were analyzed. Liver function, including total bilirubin (TB), aspartate aminotransferase (AST), alanine aminotransferase (ALT) and International Normalized Ratio (INR), was assessed before and after PVE. Any complications of TPVE and liver resection after TPVE were recorded.TPVE was performed on 18 patients before right hepatic resection for both primary and secondary hepatic malignancies (10 hepatocellular carcinomas, 4 cases of colorectal liver metastasis, and 4 cholangiocarcinomas). Technical success was achieved in 100% of patients (18 of 18). The mean FRL significantly increased to 580 ± 155 mL (P < .001) after PVE. The mean FLR/TLV ratio (%) significantly increased to 34 ± 4 (P < .001) after PVE. One patient suffered septicemia after TPVE. A small number patients experienced mild to moderate abdominal pain during TPVE. No other major complications occurred after TPVE in our study. The patient who developed septicemia died 3 days after the surgery as a result of this complication and subsequent multiple organ dysfunction syndrome (MODS).Transjugular portal vein embolization is a safe, efficacious, and promising novel technique to induce hypertrophy of the FLR.

Feasibility and Safety of Delayed Catheter Removal Technique in Percutaneous Trans-Hepatic Portal Vein Embolization

“…The main PVE approaches include trans-hepatic (including contralateral and ipsilateral), trans-ileocolic, 4 trans-splenic, and transjugular approaches. 5 …”

“…3 The main PVE approaches include trans-hepatic (including contralateral and ipsilateral), trans-ileocolic, 4 trans-splenic, and transjugular approaches. 5 However, patients undergoing PVE are more likely to have a potential hepatic disease, such as thrombocytopenia or coagulopathies, than the normal population. Therefore, in transhepatic PVE procedures, bleeding is the most common postoperative complication, occurring in approximately 2% to 4% of patients after PVE.…”