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17.04.2017 | Original Scientific Report

Combined Preoperative Portal and Hepatic Vein Embolization (Biembolization) to Improve Liver Regeneration Before Major Liver Resection: A Preliminary Report

verfasst von: Bertrand Le Roy, Antoine Perrey, Mikael Fontarensky, Johan Gagnière, Armand Abergel, Bruno Pereira, Celine Lambert, Louis Boyer, Denis Pezet, Pascal Chabrot, Emmanuel Buc

Erschienen in: World Journal of Surgery | Ausgabe 7/2017

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Abstract

Background

Insufficient volume of the future liver remnant (FLR) is a major cause of non-resectable disease in patients presenting with primary or metastatic liver tumours. The objective of this study was to evaluate the safety and efficacy of the combined preoperative portal and hepatic vein embolization (biembolization) before extended right liver resections.

Methods

This retrospective study was performed in a tertiary centre between 2014 and 2015. Combined right portal and hepatic vein embolization (biembolization) was proposed, as an alternative to ALPPS procedure, for all patients with primary or metastatic liver tumour, before right extended hepatectomy. CT scan liver volumetry was assessed before biembolization, three weeks after biembolization and one week after surgery.

Results

Seven patients underwent biembolization. All patients had right portal vein embolization (PVE) combined with right hepatic vein embolization (HVE, n = 4), median HVE (n = 2) and right + median HVE (n = 1). Three patients had preoperative liver disease and two received preoperative chemotherapy. No biembolization procedure-related complications occurred. The mean FLR regeneration rate was 52.6% (range: 18.2–187.9) after the biembolization. One patient with gallbladder carcinoma was not operated because of peritoneal carcinomatosis diagnosed after the biembolization. The remnant six patients did not develop postoperative liver failure.

Conclusions

Biembolization seems to induce safe, reproducible and effective FLR growth before extended right hepatectomy, in patients with primary or metastatic liver tumour.

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Titel: Combined Preoperative Portal and Hepatic Vein Embolization (Biembolization) to Improve Liver Regeneration Before Major Liver Resection: A Preliminary Report
verfasst von: Bertrand Le Roy
Antoine Perrey
Mikael Fontarensky
Johan Gagnière
Armand Abergel
Bruno Pereira
Celine Lambert
Louis Boyer
Denis Pezet
Pascal Chabrot
Emmanuel Buc
Publikationsdatum: 17.04.2017
Verlag: Springer International Publishing
Erschienen in: World Journal of Surgery / Ausgabe 7/2017
Print ISSN: 0364-2313
Elektronische ISSN: 1432-2323
DOI: https://doi.org/10.1007/s00268-017-4016-5

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Abstract

Background

Methods

Results

Conclusions

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