Abstract：
BACKGROUND:Right portal vein embolization has become popular in preparation for right hepatic lobectomy. However, right trisegment portal vein embolization (R3PE) is not well established. METHODS:We performed R3PE in 15 patients with biliary tract carcinoma and 1 patient with primary sclerosing cholangitis. We used 2 types of 5.5 F triple-lumen balloon catheters to embolize portal branches of the right trisegment (the left medial, the right anterior, and the right posterior segments). RESULTS:R3PE was successful in all patients without any complications. The calculated volume of the right lobe significantly (P < .01) decreased from 650 +/- 161 cm3 before embolization to 585 +/- 143 cm3 after embolization; the volume of the left lateral segment significantly (P < .0005) increased from 240 +/- 58 cm3 to 361 +/- 66 cm3. The volume of the left medial segment was unchanged. The volume gain of the left lateral segment was larger in patients with R3PE than in those patients (n = 41) with right portal vein embolization (122 +/- 39 cm3 vs 66 +/- 35 cm3; P < .0001). Two of the 16 patients underwent only laparotomy because of peritoneal dissemination, and the remaining 14 patients underwent right hepatic trisegmentectomy with caudate lobectomy. In addition, portal vein resection was also performed in 5 patients, and pancreatoduodenectomy and right hemicolectomy was performed in 3 patients. One patient died of posthepatectomy liver failure 87 days after surgery, a mortality rate of 7.1% (1/14 patients). CONCLUSIONS:R3PE is more useful than standard right portal vein embolization in preparation for right hepatic trisegmentectomy and has the potential to increase the safety of this high-risk surgery for patients with biliary tract carcinoma.
journal_name
Surgeryjournal_title
Surgeryauthors
Nagino M,Kamiya J,Kanai M,Uesaka K,Sano T,Yamamoto H,Hayakawa N,Nimura Ydoi
10.1067/msy.2000.101273subject
Has Abstractpub_date
2000-02-01 00:00:00pages
155-60issue
2eissn
0039-6060issn
1532-7361pii
S0039-6060(00)69258-9journal_volume
127pub_type
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