[Portal vein embolization: Present and future].

Abstract:

:Portal vein embolization consists of occluding a part of the portal venous system in order to achieve the hypertrophy of the non-embolized liver segments. This technique is used during the preoperative period of major liver resection when the future remnant liver (FRL) volume is insufficient, exposing to postoperative liver failure, main cause of death after major hepatectomy. Portal vein embolization indication depends on the FRL, commonly assessed by its volume. Nowadays, FRL function evaluation seems more relevant and can be measured by 99mTc labelled mebrofenin scintigraphy. Portal vein embolization procedure is mostly performed with percutaneous trans-hepatic access by using ultrasonography guidance and consists of embolic agent injection, such as cyanoacrylate, in the targeted portal vein branches with fluoroscopic guidance. It is a safe and well-tolerated technique, with extremely low morbi-mortality. Portal vein embolization leads to sufficient FRL hypertrophy in about 80% of patients, allowing them to undergo surgery from which they were initially rejected. The two main reasons of non-resection are tumor progression (≈15% of cases) and FRL insufficient hypertrophy (≈5% of cases). When portal vein embolization is not enough to obtain adequate FRL regeneration, hepatic vein embolization may potentiate its effect (liver venous deprivation technique).

journal_name

Bull Cancer

journal_title

Bulletin du cancer

authors

Piron L,Deshayes E,Escal L,Souche R,Herrero A,Pierredon-Foulongne MA,Assenat E,le Lam N,Quenet F,Guiu B

doi

10.1016/j.bulcan.2017.03.009

subject

Has Abstract

pub_date

2017-05-01 00:00:00

pages

407-416

issue

5

eissn

0007-4551

issn

1769-6917

pii

S0007-4551(17)30093-0

journal_volume

104

pub_type

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