Elsevier

Surgery

Volume 130, Issue 1, July 2001, Pages 116-118
Surgery

Brief Clinical Reports
Portal embolization relieves persistent jaundice after complete biliary drainage*

https://doi.org/10.1067/msy.2001.115358Get rights and content

Abstract

Surgery 2001;130:116-8.

Section snippets

Case report

An 81-year-old man was admitted in December 1996 for obstructive jaundice. His serum bilirubin level was 8.2 mg/dL. Biliary drainage was performed by using 3 catheters: to the right paramedian and lateral branches and to the left hepatic duct. A cholangiography (Fig 1) and abdominal computed tomography indicated the presence of a hilar bile duct carcinoma with predominant left duct involvement.

. Cholangiography showing the disruption in right and left bile duct communication at hepatic

Discussion

PE is a radiologic technique causing atrophy in the embolized region and compensatory hypertrophy in the contralateral region of the liver.2 The technique is widely performed before hepatectomy to induce hypertrophy in the future remnant liver and increase the safety of an extensive hepatectomy.2 In the current case, this technique was applied to improve liver function. PE was performed to induce functional enhancement in the selected liver sector and relieve worsening jaundice.

Pathologic and

Conclusion

Recovery of liver function may be possible in some patients with persistent jaundice after biliary drainage. If the patient has a functional disparity among liver sectors, jaundice can be relieved by a PE that induces functional enhancement of a selected sector(s). Moreover, patients may subsequently be capable of undergoing radical operation. PE should be considered as an option in patients who have persistent or worsening jaundice after biliary drainage.

References (11)

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Reprint requests: Masatoshi Makuuchi, MD, PhD, Division of Hepato-Biliary-Pancreatic and Transplantation Surgery, Department of Surgery, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan.

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