15-year experience in the use of portal vein embolization in patients with focal liver diseases

V.A. Kondratiuk

Abstract


Background. Portal vein embolization allows increa­sing the future remnant liver in patients with malignant hepatic neoplasms, preparing for radical surgical treatment. The wide spread of this technique is interfered by the lack of a single execution algorithm. The purpose of this study was to analyze 15-year experience of preoperative portal vein embolization in patients with advanced liver tumors. Materials and methods. From 2003 to 2017 in the department of endovascular surgery of O.O. Shalimov National Institute of Surgery and Transplantology of the NAMS of Ukraine, 485 preoperative embolizations of the portal vein branches were performed in patients with liver tumors, the future remnant liver in which was below the threshold resectabi­lity level. Results. As a result of portal vein embolization, it was possible to achieve the future remnant liver increase by 88.2 % (from 237 to 446 cm3). It allowed performing the radical liver resection in 421 (86.8 %) patients. The analysis of laboratory data showed that the processes of hepatocytolysis associated with embolization and reduction of the synthetic function of the liver are reversible and complete within 3 weeks. Conclusions. Preoperative embolization of the portal vein branches makes it possible to expand the range of resectability of patients with advanced liver tumors and to reduce the risk of postoperative acute hepatic insufficiency.


Keywords


portal vein embolization; extended liver resection

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DOI: https://doi.org/10.22141/1997-2938.1.36.2018.133007

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